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T <br /> everett <br /> i: �r . �, <br /> ! ' � / _.� li. � <br /> City of Everett <br /> Enqineering Department <br /> Sew�r Application and �errnit <br /> �; :� �>� � <br /> NO. L � %, 'p J DATE — <br /> Service Address Utility Account No. <br /> Billing Address . Connection Permit Fee <br /> City, State, 7_ip Connection Fee <br /> Owner (Mortgagor) , Total Fee _ <br /> 6illing Name — <br /> Connection By <br /> Address_ Signed_ _ _ <br /> � c,,.�o�„�� <br /> Pi�one_ <br /> DESCRIPTION: Sewer District ____ <br /> Lot_ <br /> Monthly Sewer Service <br /> Block <br /> Division or Addition Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: <br /> ' Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> FL12t�L1 doaie T.t�ii JJy , n', S, E, W _ it. <br /> ,e0 <br /> i�-zi-�/ <br /> Approved 8y <br /> Ciry En9ineer <br /> Issued By ____ <br /> Inspection By_ -- — <br /> Date Inspected_ — <br /> 3 <br /> SEE SKETCH ATTACHED N0. ! '1 ` <br /> i <br />