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e' rett <br />,. e <br />City of Everett <br />Engineering Department <br />Sewer Application and Permit <br />No. 21465 DATE <br />l <br />Service Address Utility Account No, <br />Billing Address Connection Permit <br />City, State, Zip Connection Fee_ <br />Owner (Mortgagor)_ Total Fee_ _ <br />Billing Name <br />Connection By <br />Address _/ eels"; <br />�` ; /7Aee'L-7- T <br />Phone ` <br />DESCRIPTION: <br />Lot <br />Block <br />Division or Addition <br />Type Permit: <br />a <br />SEE SKETCH ATTACHED <br />INSPECTION <br />Signed <br />Customer <br />Sewer District <br />Monthly Sewer Service. <br />Monthly Sewer Constr. <br />Trunk <br />Latera <br />Abutting Lot Line <br />N,S,E,W, <br />Approved <br />City Engineer <br />Issued B <br />r�t <br />Inspection By <br />Date Inspected ' <br />No. 21465 <br />, ■ <br />