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evgrea <br /> � � � � g . <br /> �`i � ��� ` /� � <br /> City of Everett J����4 <br /> Engineering Department <br /> Sewer Application anc� Permit <br /> No. ;tOG13 ✓ DATE <br /> Service Address_� 9 �� �L/C ICF C� Utility Account No. <br /> 6illing Address_— Connection Permit Fee_ <br /> City,State, Zip ' ' A '� ' Connection Fee <br /> _ ; �- s�` Total Fee <br /> Owner (Mortgagor) ' • <br /> Billing Name <br /> Connection By <br /> Address ' � �= ' Signed c�s�om�� <br /> Phone � - <br /> DESCRIPTION: <br /> Lot <br /> Block .— <br /> Division or Addition � <br /> Sewer District <br /> Monthly Sewer Service — <br /> Remarks: (������v__ <br /> Monthly Sewer Constr. <br /> � " ✓G <br /> ' - � <br /> ,.* �.�-�. <br /> ,,,, 7 i (Is� � Cu.•. <br /> a.��. � ���-�_���'. APn�o��a ey , . , <br /> Ciip Er7incer <br /> G' <br /> Issued By — <br /> Connection By <br /> Inspection By�' . �cc.i...J <br /> Date Inspected j �' » <br /> � <br /> SEF SKETCH ATTACHED <br />