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everett <br /> � <br /> City of Everett <br /> Engineering Uepartment <br /> Sewer Appliratic�n and Permit <br /> � , �, <br /> NU. DATE <br /> �_�L( - //3 `. 2F �= 5 d <br /> Service Address- '— -- ----- Utility Account No. <br /> Billing Address Correction Permit Fee <br /> Ciry, State, Zip Connection Fee <br /> Owner (Mortgagor�_ _ Tot;al Fee_ <br /> Billing Name <br /> Connection By <br /> Address Signed_._ <br /> Customer <br /> Phone_ <br /> DESCRIPTION: Sewer District <br /> Lot <br /> Block_ Monthly Sewer Service <br /> Division 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 Engincer <br /> Issued 6y <br /> < <br /> inspection By_��2 -�'�-r!— <br /> Date Inspected ,z/3/h-� <br /> o —� <br /> SEE SKETCH ATTACHED NO. ' i �i `, ' <br />� <br />� <br />