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everett <br /> e _. . ; <br /> ; <br /> City of Everett �, �'�_, � , <br /> Enyineering Department <br /> Sewer Application and PPra�it <br /> N0. �- � � ' �� �� DATE <br /> Servir.e Address <br /> 3 7 O�O �1�/ e _ Utility Account No. <br /> Connection Permit Fee_----- <br /> Billing Address <br /> Connection Fee <br /> City,State, Zip <br /> Total Fee <br /> Owner (Mort�agor) <br /> Billing Name <br /> Connection By <br /> Signed Customer <br /> Address <br /> Phone '—'—" <br /> 6ewer District <br /> DESCRIP ION: <br /> Lot� Monthly Sewer Service <br /> Block� <br /> Division or Addition �� �-•-� Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: Lateral <br /> � � <br /> , �,,. ec. <br /> Remarks: � Abutting Lot Line ft. <br /> -- N, S, E, W <br /> �4(1pfOVBd By ��t�Engineer <br /> Issued By <br /> — -- ,� � <br /> --- Inspection By <br /> �'�--',�'�'�,w--— <br /> Datelnspec:ted��/7 � <br /> � NO. ' i: _ . <br /> SEE SKETCH ATTACHED <br />