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everett � � � <br />City of Everett <br />Engineering Department <br />Sewer Application and Permit <br />NO. 20671 DATE -- <br />Service Address <br />Billing Address <br />City, State, Zip <br />Owner (Mortgagor) <br />Billing Name <br />Connection By — <br />Utility Account No.. <br />Connection Permit F <br />Connection Fee_ <br />Total Fee <br />Signed <br />cwromer <br />Phone _ <br />DESCRIPTION: <br />Sewer District__ <br />Lot <br />Monthly Sewer Service. <br />Block <br />Division or Addition <br />_ Monthly Sewer Constr. <br />Type Permit: <br />Remarks: <br />a <br />SEE SKETCH ATTACHED <br />Lateral <br />4butting Lot Line <br />N, S, E, W. <br />Approved By <br />City Engineer <br />Issued <br />Inspection By k/2 <br />Date I nspected <br />NO. 20671 <br />