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� <br />� <br />� <br /> everett <br /> � -� -� -�- � <br /> City of Ec erett <br /> Engineering O,partment <br /> Sew�r Application and Pe�mit <br /> N0. DATE <br /> Service Address___ Uti!ity Accowit No. <br />` Connectioc Permit Fee — <br /> Billing Address <br /> City, State, Zip <br /> Connection Fee <br /> Owner (Mortgagor) Total Fee — <br /> Billing Name <br /> Connection By <br /> Signed_ — <br /> Address Cuswmrr <br /> Phcne <br /> DESCRIPTION: Sewer District -- <br /> Lot Monthly Sewer Service__— <br /> Block <br /> pivision or Addi'ion Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: <br /> Lateral <br /> Remarks: Abutting Lot Line <br /> N S E W ft. <br /> Approved By <br /> City Engineer <br /> _ Issued By -- — <br /> Inspection By — <br /> i <br /> Gate Inspected <br /> 3.—._——-- — �.� ,� ,,— , <br /> SEESKETCH ATTACHED NO. . <br />