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everett <br />� <br />City of Everett <br />Engineering Department <br />�./ ; -, � - _ <br />���, - i. � � - <br />� _ ,c�. �� •,. <br />,._j. ,- .._ <br />Sewer Application and Permit <br />NO. L �I �.j ;', .`i DATE <br />Service Address Utility Account No. <br />Billing Address <br />Connection Permit I <br />City, 5tate, Zip Connection Fee_ <br />Owner (Mortgagor) Total Fee <br />6illing Name <br />Connection By <br />Address Signed__ <br />Phone <br />c�s����,�� <br />DESCRIPTION: Sewer District <br />Lot Monthly Sewer Service. <br />Block_ <br />Division or Addition Monthly Sewer Constr. <br />T...... D�....i1• <br />SEE SKETC4 ATTACHED <br />'rru nk <br />Lateral_ <br />Abutting Lot Line <br />N, S, E, W_ <br />Approved <br />Issued <br />Inspection <br />Datelnspe <br />Engineer <br />rva ;'�$95 <br />.,.... t . .r:a,.�... .+iti+-. ... ....1.. .._ ,�'.ue+..F"� .,+I ,. .-.�yar .�e..,...��4.:::✓Yr.r;:l'iL.:w#•i� . _....«...�.�.,�.•.+.; <br />