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everett ,�O �,��/, <br />� <br />� ( <br />e � �e � ��L���s <br />�a= <br />City of Everott <br />En�ineerin� Dep�rtment Tq <br />Sewer Application and Permit <br />No. 2093� DATE �I . <br />� ; <br />Service Address�_ `'' r� ' Utility Account No. <br />Billing Address_ � <br />City, State, 2ip � <br />Owner (Mortgagor) <br />Billing <br />Connection <br />Address <br />Connectio� Permit <br />_ Connection <br />Phone 3S 3— Z r/ 3� _ <br />Total <br />Signed <br />cuctomer <br />DESCRIPTION: Sewer District <br />Lot <br />B��k Monthly Sewer Service <br />Division or Addition Monthly Sewer Constr. <br />Tvae Permit: <br />SEE SKETCN ATTACHED <br />WSP[CTION <br />Trunk <br />Abutting Lot Line <br />N, S, E, W. <br />Approved By <br />City Enqineer <br />ISSUCfJ <br />Inspection By_ <br />�/:.^'. ,;in!? <br />� " 'I <br />` ..�.:� �;; � <br />J"'' - ' '_' <br />+ �i <br />' ^.' ll l <br />;�i�r ^:; 1�75 _ <br />Datelospected___ '"""'— <br />Y 0: _, _ ;ETT <br />rvo. �4g39�:. ,:. <br />