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' everett <br />City of Everett <br />Engineering Department <br />Sewer Application and Permit <br />NO. r2 _L 5 3 5 DATE <br />�3':2 e7 <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 />a <br />SEE SKETCH ATTACHED <br />Utility Account No <br />Connectior Permit F <br />Connection F <br />Total Fee <br />signed_ -- <br />Cwtoiner <br />SeA,pr District <br />Month'y Sewer Service <br />Monthly Sewer Constr. <br />Tru <br />Abutting Lot Line <br />N, S, E, W <br />Approved By <br />City Engineer <br />Issued <br />Inspe,tion By ' AOAC�� <br />Date Inspected/ 7/7 7 <br />NO. 21535 <br />