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everefl <br />•� - _ .��:, <br />� -� � , �� ��<-, <br />; , � <br />City of Everett <br />Engineering Department <br />,� <br />� _ _.��- <br />5 <br />Sewer Application and Perr�it <br />No. 20736 DATE <br />Service Address <br />Billing Address — <br />City, State, Zip " - --- <br />Owner (Mortgag�r�_ <br />Billing Name � <br />Connection By ' "'"' ' <br />Address ii L-: �- <br />Phone_� ��" — <br />DESCRIPTION: <br />Lot <br />Block _ <br />Division or Addition � �' ' ' <br />Utility Account No. <br />Connection Permit i <br />Conner.tion Fee__ <br />Total Fee_ <br />Signed <br />SEE SKET�:H ATTACHED <br />Sewer District <br />Monthly Sewer Service. <br />Monthly Sewer Constr. <br />Trunk <br />Lateral_ _ <br />Abutting Lut �ine <br />N, S, E, W. <br />Approvn_d By <br />City Engineer <br />Issued B <br />. <br />,, � / � - % /�-�; !� %��� <br />Inspection 81�(� .— �=' <br />Date InspectedL.�;.�� �- -I� � <br />NO. � n ! �' C <br />