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'�"veren <br />e ����0����-�`�: <br />� � g/i .�/, �-- <br />�� s �� ( _, <br />City of Everett /�i� <br />��.rvc_ <br />Engineering Department <br />Sewer Application and Permit� <br />No. 2pgg,� DATE <br />Service Address <br />Billing Address <br />City, State, Zip <br />Owner (Mortgagor) <br />Billing Name <br />Connection By <br />Phone <br />DESCRIPTION: <br />Lot —T—" /CO <br />Block <br />Division or Addition_ <br />Typ'a Permit <br />Utility Account No. <br />Connection Permit I <br />Connection Fee_ <br />Total Fee <br />Signed <br />Customer <br />3 <br />SEE SKETCH ATTACHED <br />G'._, ��_Cllili�i <br />Sewer District <br />Monthly Sewer Service <br />Monthly Scwer Constr. <br />Trunk <br />Lateral <br />Abutting Lot Line <br />N, S, E, W, <br />Approved By_ <br />Ciry Engineer <br />Issued <br />Inspection By �G�%— �• <br />Date inspectc�_ / <br />rvo. ?f)9�n <br />