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everen <br />� <br />City of Everett <br />Engineering Department <br />� <br />Sewer Application c�nd Permir <br />N0. 2 O 6 4.�.i DATE �� � I— ,�9 <br />/i tie9 <br />Service Address �+'n�_�� ��- '�� � �tili:y Account No. <br />Billing Address <br />City, State, Zip <br />Owner (Mortgagor) <br />Billing Name <br />Connection By <br />Phone <br />Connection Permit <br />Connection <br />Total Fee �° <br />Signed <br />Cusmmer <br />DESCRIFTION: Sewer District <br />Lot � <br />Montnly Sewer Service_ <br />Block �/ <br />Division or Addition SC,�Jb�k'C'r. ��Lld�llZ Monthly Sewer Constr. <br />SEESKETCH ATTACHED <br />Latera I <br />Abutting Lot Line <br />N, S, E, W <br />.4oproved By <br />Cily Engineer <br />Issued <br />Inspection By <br />Datelnspected <br />fV 0. ' � ��_ , . ; i <br />