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Ll <br />City of Everett <br />Engineering Department <br />1C6-zco/ -5 3�DSN£P 3/7/7S <br />Sewer Application and Permit <br />NO. 20726 DATE <br />Service Address L24= • <br />Billing Address - <br />City, State, Zip _ -_____ ___— 1 !1 „ <br />Owner (Mortgagor) 4�^ �< <br />Billing Name <br />Connection By fit= •i G' <br />Address T' 1.= '. �4:z <br />Phone_ a -Tr-; <br />DESCRIPTION: <br />Lot <br />Utility Account No. <br />Connection Permit I <br />Connection Fea_ <br />Total Fee <br />Signed <br />Curtom.r <br />Sewer District <br />Block Monthly Sewer <br />Division or Addition - ' • U r , • F_ Monthly Sewer Constr. <br />Type Permit: <br />Remarks: <br />SEE SKETCH ATTACHED <br />Trunk <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved By _ <br />City Engineer <br />Issued <br />is <br />Inspection By <br />Date lnspected 7 7 <br />NO. 20726 <br />