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--�_.--. . . . . _ <br /> ; <br /> z <br /> Kverett � <br /> ' } i:�,�('�P <br /> � � �� 3o- z4-r�F/7/�� <br /> � <br /> City of Everett <br /> Engineering Department ` . <br /> Sewer A�plication and Permit ' <br /> N0. % _' ;; �-' � DATE <br /> Service Address Utility Account No. i <br /> Billing Address _ Connection Permit Fee �i <br /> City, State, Zip <br /> Connection Fee <br /> Owner (Mortgagor)_ Total f-ee <br /> Billing Name_ � <br /> Connectior. By <br /> Signed — <br /> f1dC�f8S5_ Cusromer <br /> Phone <br /> Sewer District — <br /> DF.SCRIPTION: <br /> Lot Monthly Sewer Service <br /> Blcck — <br /> Division or Addit'on Monthly Sewer Constr. <br /> Trunk <br /> Type Permit• Lateral <br /> Remarks: Abutting Lot Line <br /> N S E W ft. <br /> Approved By <br /> City Enginecr <br /> Issued BY <br /> Inspection By " <br /> Date Inspecte.d <br /> a NO. � ' � ' ` �� ; <br /> SEE SKETCH ATTACHED <br />