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cvcrctt <br /> City of Everett <br /> Engineering Department <br /> Sewer Application and Permit 33565 <br /> NO. 20664 DATE <br /> Service Address - _ _ Utility Account No. <br /> Billing Address _ Connection Permit Fee_ <br /> City, State, Zip Connection Fee <br /> Owner (Mortgagor) _ Total Fee_ <br /> Billing Name <br /> Connection By--- <br /> Address— <br /> y_ _Address_ ___ Signed_ <br /> Cmlomer <br /> Phone------- <br /> DESCRIPTION: <br /> hone _ _—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 /> N, S, E, W ft. <br /> Approved By-- <br /> City Engines <br /> -- Issued By. - <br /> Inspection By <br /> Datt Inspected <br /> a <br /> SEE SKETCH ATTACHED NO. �2 0 6 6 4 <br />