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.ett <br />Le, <br />City of Everett <br />Engineering Department <br />Sewer Application and Permit <br />NO. 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 />Block <br />Division or Addition <br />Type Permit: <br />SEE SKETCH ATTACHED <br />Utility Account No. <br />Connection Permit I <br />Connection Fee_ <br />Total Fee <br />Signed <br />Cussomor <br />Sewer District_ <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Trunk _ <br />Lateral <br />Abutting Lot Line <br />N, S, E, W. <br />Approved By <br />C , Engineer <br />Issued <br />Inspection By l <br />Date Inspected V76 <br />No. 21386 <br />