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everetl <br /> e ��s��-� <br /> City of Ever t I � .-� (� . !` <br /> Engineering �epanment / � � `J <br /> �--�- <br /> Sewer Application and Permit <br /> NO. DATE <br /> Service Address Utility Account Na._._ <br /> Billing Address Connection Permit Fee <br /> City, State, Zip Connection Fee <br /> Owner (Mortgagor) Total Fee_ <br /> Billing Name <br /> Connection By <br /> Address Signed ____ _ <br /> c���,�R,e�— <br /> Phone <br /> DESCRIPTION: Sewer District_ <br /> Lot <br /> Block Monthly Sewer Service <br /> Division or Addition Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: -- <br /> Lateral <br /> Remarks: a-i� � e <br /> — Abutting Lot Line <br /> N, S, E, W ft. <br /> Approved By <br /> City EnO��eer <br /> Issued By <br /> � <br /> Inspection By �/-.•�_- � `'J.��� ��� ;� � _ <br /> Date Inspected _ <br /> o— — <br /> SEE SKETCH ATTACHED NO. �' . <br />