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L61 <br />City of Everett <br />Engineering Department <br />Sewer Application and Permit <br />NO. 91 356 DATE <br />Service Address_ <br />Billing Address_ <br />City, State, Zip__ <br />Owner (Mortgagor), <br />Billing Name_ <br />Connection By__ <br />Phone -- <br />DESCRIPTION: <br />Lot <br />Block_ <br />Division cr Addition <br />Type Permit: <br />tsemartcs: <br />SEE SKETCH ATTACHED <br />Utility Acco:-nt No.. <br />Connection Permit F <br />Connection Fee_ <br />Total Fee - <br />Sewer District__ <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Trunk___ <br />Lateral - <br />4butting Lot Line <br />N, S, E, W <br />Approved By <br />City Engineer <br />Issued <br />Inspection By rc <br />Date I nspected_ �O <br />No. 21356 <br />