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everett , _;, <br /> � , ; C� - . <br /> City of Everett �� - �'�� "� �' � �1 <br /> Engineering Department <br /> Sewer �4pplication and Permit <br /> r, ., __ . <br /> N0. �_ . _ DATE <br /> Service Address _ Utility Account No. <br /> Billing Address Connection Permit Fee <br /> City,Siate, Zip _. Connection Fee <br /> Owner (Mortgagor� Total Fee <br /> Billing Name <br /> Connection By_ <br /> Address Signed__ <br /> Customcr — <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot <br /> Block Monthly Sewer Service_. <br /> Givision or Addition Monthly Sewer Constr. <br /> Type Permit: Trunk _ <br /> Lateral_ _ <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. ' <br /> _ � <br /> Approved By <br /> Ciry Enqinccr <br /> Issued By <br /> Inspection By <br /> e Date Inspected <br /> SEE SKETCH ATTACHED N0. `� ! ; ; <br /> _ _ . . I <br /> I <br /> '� ..,.. � .—a� ._ � - , <br />