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everett <br />City of Everett <br />Engineering Department <br />Sewer Application and Permit <br />NO. 20724 DATE <br />Service Address_ <br />Billing Address <br />City, State, Zip <br />Owner (Mc,tgagor( <br />Billing Name <br />Connection Bv_ <br />Utility Account N( <br />Connection Permit <br />Connection Fee <br />Total Fee <br />Signed <br />Cwnro r <br />DESCRIPTION: Sewer District <br />Lot <br />Block_._ Monthly Sewer Service _ <br />Division or Addition Monthly Sewer Constr. <br />Type Permit: Trunk <br />SEE SKETCH ATTACHED <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved By_ <br />City Engineer <br />Issued <br />Inspection By -p <br />)ate Inspected_ � Z7 <br />71-7 <br />NO, 20724 <br />