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evcritt s'Tmi> N-3o-t9 -s— <br />�_ 3o-tq-S <br />City of Everett 1 <br />Engineering Department <br />Sewer Applicurion and Permit <br />NO. 21088 DATE <br />Service Address_ <br />Billing Address_ <br />City, State, Zip_ <br />Owner (Mortgagor) <br />Billing Narne <br />Connection By — <br />Phone <br />DESCRIPTION: <br />Lot <br />Division or Add <br />Type Permit: <br />Remarks: <br />SEE SKETCH ATTACHED <br />Utility Account No <br />Connection Permit <br />Connection Fee_ <br />Total Fee <br />Signed_ <br />Customer <br />Sewer District___. <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved By__ <br />City Engineer <br />Issued ' <br />Inspection By--"I <br />Date Inspected z <br />No. 21088 <br />