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/ � <br /> �verett i ,7 � Z � " > <br /> � � ia✓✓ 5 /"��'/� <br /> � 6/jo/>.i <br /> City of Everett �s ��, <br /> Engineerinp Oepartment <br /> Sewer Application and Permit <br /> , � .> ,� � :: �.�� � <br /> N0. r� Q � 1. � DATE _, ' <br /> Service Address ' ' < � `��� Utility Account No. <br /> Billing Address � ��- � Connection Permit Fee ___ <br /> City, State, Zip �'•,�// L L'/;� i�l� . i, . Connection Fee <br /> Owner (Mortgagor) - ` / - � i ' ,�'�r' � _ Total Fee <br /> Billing Name ' <br /> Connection By ' ` <br /> Address \ ( —" Signed <br /> Cusinmer <br /> Phone <br /> DESCRIPTION: f`37-1/y� ��-��Qd *� Sewer District 1.+- ✓ `�_ _ <br /> l.ot •.--.�. , i 8e.� �.�t�C. <br /> 81ock 2 Monthly Sewer Service_ _ _ <br /> Division or Addition � � - � _ Monthly Sewer Constr. <br /> .,_ i _ � io <br /> � --- Trunk � <br /> Type Permit: � , , � �'.t n_'[ c" i� r .�--' <br /> ZU <br /> �c1 ;< •'/ ,;� n Lateral ��p � <br /> Ren�arks: -; ;�'.,�. � � .. �• � <br /> / �, / ' / �- A�utting Lot ine � ��� �1 <br /> _���ld.�G2�.o�i1��X/L�G��Ldr/Y OF � � N, S,�E� W --- it. <br /> _5�..�.�"7"t�� <br /> T���Yal,. 1�.�,Jfi�,t�zr,� .57'a/�, l%,m.F.�; • � <br /> /1.c.:rE-s5'�ay_/>.tl�all�J- 1'i'.�.ri4s,L�OG <br /> �� Approved 8Y— -- <br /> .1G'����aZ'�' __ _ CitV Enginrer <br /> . L�.._!!��L�-a-x^�v .6�n-JrilS 'eLG%� f%Fidf�l/�y�'�e <br /> T Issued By______ __ _ <br /> l<ry,7rc✓%QG �&.rr�- on—ca.,srw� d`-� ;�/.1e�u _----- -- <br /> ��u S�Nm. �.r�_r /•i�10 Gri ' s • �ry���� �/Z5/�� <br /> / <br /> -- -- Inspecuon By�%sc{'�=�-` '<.,�.' -- ---- <br /> --- --- �� <br /> -- - - —___..._. - <br /> _—-- — Date Inspe„ted��/rlrc .�-_--.._— <br /> a - — <br /> SEE ;iKETCH ATTACHED N0. <br />