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i <br /> fVC'rp <br /> � .'i <br /> City of Everett � <br /> Engineedng Department I�` , '+' 1' <br /> Sewer Application and P�rr�itP % <br /> � ,; <br /> N0. n DATE i <br /> Service Address ' + Utility Account No. <br /> - • � Connection Permit Fee <br /> Billing Address <br /> • Connection Fee <br /> City, State, Zip <br /> Owner (Mortgagor) <br /> � Total Fee <br /> Billing Name <br /> Connection By <br /> A(1df055 S�9�ed_ Customer <br /> Phone <br /> Sewer District <br /> UESCFIPTION: <br /> Lot Monthly Sewer Service.__-- <br /> Block <br /> Division or Addition ' ' Monthly Sewer Constr. <br /> Tr�nk _— <br /> Type Permit: — Lateral <br /> Femarks: Abutiing Lot Line ft. <br /> N, S, E, W <br /> QPpfOVBd BY Citv EnBineer ' <br /> Issued By <br /> Inspection 8y <br /> Datelnspected <br /> a NO. � <br /> SEE SKETCH ATTACHED <br />