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e _ _�t - �•; <br />� � ���; ;; j <br />+� � ; � <br />�f �>���-. <br />Ciry of Everett <br />Engineering Oepartment <br />Sewer Application and Permit' <br />r�o. 2 Q g�� � DATE <br />Service Address <br />Billing Address _ <br />City, State, Zip <br />Owner (Mortgagor) _ <br />Qilling Name <br />Connection By <br />Address <br />Phone .. _ <br />Utility Account No <br />Connection Permit <br />Connection Fee_ <br />Total Fee_ _ <br />Siqned <br />' q� 6�j �_ <br />DESCRIPTION: Sewer District _ <br />Lot __ <br />Block Monthly Sewer Service <br />Division or Addition Monthly Sewer Constr. <br />Type Permit: <br />SEE SKFTCH ATTACHED <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved By_ <br />Ciry Enginecr <br />ISSUCfj <br />�nspection By y't�/`�� }� �� <br />Date Inspected ; �� ��'s� <br />/ <br />No. ? �� �l 41. <br />