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everNt , , <br /> � ��': ��G' �'��" .` ..�.. <br /> f�,`..�7^'� � i� <br /> City of Everett <br /> Engineering Department ���� �� <br /> Sewer Application and Permit <br /> N0. [_ J .: _ � DATE � <br /> Service Address Utility Account No. <br /> Billing Address Connection Permit Fee <br /> City, State, Zip Connection Fee <br /> Owner (Mortgagor) Total Fee <br /> Billing Name <br /> Connection By <br /> Address <br /> Signed <br /> cu:�ume, <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot <br /> Block_ Monthly Sewer Service <br /> Division or Addition Monthly Sewer Constr. <br /> Type Permit: Trunk <br /> — Lateral <br /> Remarks: — <br /> Abutting Lot Line <br /> N� S� E� W ft. <br /> Approved By <br /> City Enpinear <br /> Issued By <br /> _ Inspection By <br /> o Date !nspected�_G� <br /> SEE SKETCH ATTACHED N� �;� � a � � <br /> � � � <br />