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everetl � • " <br /> ELL-i4L <br /> I <br /> City of Everett <br /> lrngineemig Depart cent <br /> Sewer, Application and Permit <br /> N0. 040 %533 DATE _- -- — <br /> Service Address -�08 Q Utility Account No. <br /> Billing ddress Connection Permit Fee <br /> City, State, Zip Connection Fee <br /> Owner (Mortgagor) Total Fee <br /> Billing Plame <br /> METR�,vn� ij�N Cews , co,Ivr, <br /> Connection By <br /> Address SignedAA`t *tee Yke rl) <br /> Cuelumer <br /> Phone_------.---- <br /> DESCRIPTION: t <br /> Lot <br /> Block--- <br /> Division <br /> lock_.Division or Addition_ - _ - <br /> Sewer District <br /> -- --- Monthly Sewer Service <br /> Remarks: _ <br /> "---'- Monthly Sewer Constr. <br /> t !c ' kl 4, 2 ' V04 s' <br /> Approved By <br /> City Engineer <br /> Issued By. <br /> Connection By <br /> "— Inspection By <br /> —_ Date Inspec'Ed 7�1 <br /> SEE SKETCH ATTACHED <br /> If"SPCf'1IOP! <br />