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� <br />everett <br />e- _ :��� - � <br />City of Everett <br />Enpineering Department <br />Sewer Application and Permit <br />N0. DATE <br />Service Address Utility Account No.. <br />Billing Address — Connection Permit F <br />City, State, Zip Connection Fee_ <br />Owner (Mortgagor) Total Fee <br />Biliing Name <br />Connection By • � <br />,/� i _ .-� %' 1 <br />DESCRIPTION: <br />Lot <br />Block <br />Division or Addition <br />Signed <br />Customer <br />Sewer District <br />Monthly Sewer Service_ <br />Monthly Sewer Constr._ <br />a <br />SEESKETCN ATTACHED <br />Approved By ^ <br />City Engineer � <br />I SSUB(I <br />Connection By <br />��J��� �('�� <br />Inspection By <br />Datelnspected �'���`� <br />