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. . . i s--' . . � . <br /> "everett . _� . " <br /> • � . , ' � - <br /> e .� _ ��_�_�� _ ._j_ <br /> _ _ ,. . . <br /> City of Everett ' <br /> Enpineering Depertment <br /> Sewer �►pplication aR d Permit I , <br /> , � iN0. �- , . DATE <br /> Serwce Address.. _ _ Utility Account No. <br /> Billing Address Connection Permit Fee <br /> City,State, Zip Connectian Fee <br /> Owner (N;ortgagor) _. Total Fee <br /> Billing Narr•e <br /> Connection Ety <br /> Address_ Sianed <br /> Cmmmer --- <br /> Phone <br /> DESCRIPTION: Sewer District_ <br /> Lot _ �-'-' — �3 � % `� . � � — <br /> Block Monthly Sewer Service <br /> Division or Addition_ Monthly Sewer Constr. <br /> Type Permit: Trunk <br /> Lateral <br /> Remarks: `� a , � � <br /> �� ��'—�"`�= ^ Abutting Lot Line <br /> —�` —��—w� a cl��.- � N, S, E, W <br /> — ft. <br /> a�' /�z 3 ' /��.L %�L <br /> ,q.� /�,�,, � _ <br /> _��s <br /> Approved By <br /> City Engincer � <br /> Issued By <br /> __ Inspection By.1j�_,�c�,�_ <br /> p Daie Inspecied G —� — �]bu <br /> SEE SKETCH ATTACHED N� n q �• � � <br />