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everen <br />City of Everett <br />Engineering Department <br />Sewer Application and Permit <br />me <br />Service Address_. <br />Billing Address` <br />City, State, Zip_ <br />Owner (Mortgagor)_ <br />Billing Name <br />Connection By_ <br />Address <br />Phone <br />DESCRIPTION: <br />Lot <br />Block <br />Division or Addition. <br />Permit: <br />Remarks: <br />[)A It <br />SEE SKETCH ATTACHED <br />Utility Account No. <br />Connection Permit I <br />Connection Fee_ <br />Total Fee <br />Signed _ <br />Cmramo <br />Sewer District -- <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Lateral <br />Abutting Lot Line <br />N, S, E, W. <br />Approved By <br />Ciry Enpingr <br />Issued 8 <br />Inspection By ?arcp✓ <br />Date Inspected �7 -7 <br />NO. <br />