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Ever et, <br />e <br />City of Everett <br />Engineering Department <br />Sewer Application and Permit <br />No. 2127'4 DATE <br />Service Address Utility Account <br />Billing Address <br />City, State, Zip <br />Owner (Mortgagor) <br />Billing Name_ <br />Connection By _ <br />Address <br />Phone <br />Connection Permit <br />Connection Fee <br />Total Fee <br />.13d. <br />ee <br />Signed <br />C/' �• Customer <br />DESCRIPTION: Sewer District_ <br />Lot Block Monthly Sewer Service <br />Division or Addition Monthly Sewer Constr. <br />Type Permit: <br />Remarks: ` [rL ti <br />3 3 d0 QQ IEFF, <br />Ikk--PEc-TEfl. 3�=-L_oWo <br />111 <br />SEE SKETCH ATTACHED <br />IN; - 'i-CTION <br />Trunk �= • 1 <br />Lateral % & �L <br />Abutting Lot Line <br />N, S,: E, W <br />Approved By / / /' <br />City Engineer <br />Issued By. e "'. , '/'-' <br />Inspection By <br />Date Inspected <br />No. 21274 <br />