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evered <br />e �� <br />�5 ;�� <br />City oi Everett � '� � <br />Engineering Depnrtment <br />Sewer Applica�yon a�d Permit <br />NO. [ I����;�r DATE <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 />Blor.k._ — <br />Division or Additiar. <br />Type Permit: <br />Remarks: <br />�.i `- �1/ /� <br />���7'11� I"/ ! iT t/. r NO n lJ <br />Utility Account No._ <br />Gonnection Permit Fee <br />Connection <br />T'otal Fce <br />Sic�ned------ <br />---cl�,�o�,;��,- �---- -------- <br />SEE SKETCH ATTACHED <br />Sewer District <br />Monihly Sewer Service <br />Monthly Sewer Constr. <br />Trunk <br />Laterl <br />Abuttiny Lot Line —� <br />N. S. [. W_ - - - - - _ ---f t. <br />Approved E3y. --------- - <br />c�iv ��,�i,�,�,,,� <br />Issued [3Y- ---- . .. <br />Inspection 8y��1>'� C2cja_./- <br />�atelnspected_ �/i6��y . - - <br />NO. <br />