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pycretl <br />r— <br />City of Everett <br />Engineering Department <br />Sewer Application and Permit <br />NO. 20823 DATE _— <br />Service Address i:l( I _ � I ____— <br />Billing Address `A rF"' <br />City, State, <br />Owner (Mortgagor) d/ (. e. <br />Billing Name_ I t /` t r <br />Connection <br />Utility Account No. <br />Connection Permit Fee — <br />Connection Fee i <br />Tutal Fee r" , <br />Address_ 4A- Signed <br />Customer <br />Phone_ <br />DESCRIPTION: Sewer District <br />Lot _ <br />Block_ I Monthly Sewer Service <br />Division or Addition <br />Type Permit: <br />Remarks: <br />SEE SKETCH ATTACHED <br />Monthly Sewer Constr <br />Trunk <br />Lateral <br />Abutting Lot Line <br />N, S, E, W_ <br />Approved By <br />City <br />Issued By <br />Inspection By/olK -- <br />Date Inspected /!— Z2 ?/ <br />NO. "'f)!{" ). <br />