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^ ! . . <br /> ever�tt ; � : — <br /> � �� , <br /> ,i�. <br /> ��� <br /> City of Everett <br /> Engineering Department <br /> Sewer �►pplication and Permit <br /> �. � � �� �; <br /> � -,n �. _ . <br /> N0. �- �' J ,� •' DATE ___ <br /> r <br /> Service Address � ' Utility Account No. <br /> Billiny Address Connection Permit Fee <br /> City, Siate, Zip Connection Fee <br /> Owner (Mortgagor) Total Fee <br /> Billiny Name <br /> Connection By <br /> Address ' Signed <br /> customer <br /> Phone � -- <br /> DESCRIPTION: <br /> Lot <br /> Block_ <br /> Divisian or Addition <br /> Sewer District <br /> — Monthly Sewer Service <br /> Remarks: ;.-/� <br /> Monthly Sewer Constr. <br /> (y„_.,,.,� , �• ZJ'� a 3 ��.2—���.� APPro�ed BY . �. <br /> ",.`•.��- `� Citv Enyinccr <br /> i <br /> 3� / n S�Pv'�__� f��-P� '- Issued By <br /> 1 <br /> Connzction By <br /> Inspection By �/ --���"–^�' <br /> Datelr.spected �� �� <br /> .v7 <br /> SEE SKETCH ATTACHED <br /> r <br />