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� <br />everetl <br />e� � � � � _ � ����� <br />�, <br />City of Everett <br />Engineering Department j <br />Sewer Application and Permit ' <br />��:. �: <br />NO.� �35J DATE � <br />3- ?-6 -3/S-oa <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 />naa..,�� � Signed � ' ^-__ <br />DESCRIPTION: <br />Lot — <br />Block_ <br />Division or Addition <br />� <br />Sewer District <br />Monthly Sewer Service <br />Monthly Sewer Canstr. <br />� --- <br />SEE SKETCH ATTACHED <br />Approved By <br />CnV EnA�necr <br />I ssu ed <br />Connection By���� — <br />Inspection By.�l�—� pV r �' — <br />Datelnspected_ __��—L�--- --- <br />