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everett <br />� � -,1'=> /, ` ,� ' ��,/`. <br />i <br />City of Everett <br />Engineering Oepartment <br />� <br />��� , '�., <br />Sewer Application ond Permit <br />No. 2_0735 <br />Service Address <br />Billing Address <br />City, State, Zip <br />Owner (Mortgagor) <br />Billing Name <br />Connection By <br />Address _ <br />DESCRIPTION: <br />Lot _ <br />Block <br />Uivision or Addition <br />Type Permit: <br />DATE <br />Utility Account No.. <br />Connection Permit F <br />Cannection Fec_ <br />Total Fee <br />Signed <br />Sewer District <br />Monthly Sewer Service <br />hionthly Sewer Constr. <br />Lateral <br />Abutting Lot Line <br />N, S, E, W_ <br />Approved 8y <br />cu� <br />Issued Bv <br />Inspection 6y __ <br />Date I nsnected <br />0 <br />SEE SKETCH ATTACFiED N0. <br />