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everett _ ✓:f .. <br />City of Everett <br />Engineering Department <br />Sewer Application and Permit <br />NO. <br />DATE <br />Service Address > %'- /"' Utility Account No. <br />Billing Add; css <br />City, State, Zip <br />Owner jMortgagnr)_ 2r-S C LlL <br />Billing Name <br />Connection By <br />Connection Permit Fee <br />Connection <br />Total Fee I w/ ,-' <br />Signed <br />Customer <br />DESCRIPTION: <br />Lot <br />Block - /r <br />Division or Addition <br />Sewer D <br />Monthly Sewer <br />Remarks: <br />Mo <br />Ap <br />t r( <br />Isst <br />- <br />— - — -- <br />Co <br />- -- <br />Ins <br />Dal <br />J <br />SEE SKETCH ATTACHED INSPECTION <br />ithly Sewer Constr._ <br />)roved <br />City Engineer <br />ed By. — — <br />)nection <br />)ection By . <br />el <br />