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evere,tt % � <br />e � -; <br />� -� <br />�`=`'o--.y- •� ;.����� L_-. <br />✓� <br />City of Everett <br />Engineering Department <br />Sewer Application and Permit <br />No. 20778 DATE . '- ,': _ <br />Service Address ' ' � � � - - j�, � .-: <br />Billing Address- � `-'�- <br />CitY, State, Zip ' F' �_ -•- - <br />Owner (Mortgagor� <br />Billing Name - <br />Connection BV _ , , <br />DESCRIPTION: <br />Lot <br />Block_ � <br />Division or Addition <br />Type Perrnit: <br />Remarks: <br />Utility Account No._ <br />Connection Permit F <br />Connection Fee_ <br />Total Fee - <br />Signed <br />Customer <br />SEESKETCH ATTACHED <br />Sewer District <br />Montlily Sewer Service <br />Monthly Sewer Constr. <br />Abutting Lot Line <br />N, S, E, W <br />Approved By <br />Ciry Engincer <br />Issued <br />Inspection L'y_/�/1 <br />Datelnspected /� % <br />NO. . <br />