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everelt <br />:fas/Et7 <br />City of Everett <br />Engineering Department <br />Sewer Application and Permit <br />NO. 20725 DATE <br />Service Address <br />Billing Address <br />City, State, Zip <br />Owner (Mortgagor) <br />Billing Name_._ <br />Connection By — <br />Address _ <br />DESCRIPTION: <br />Lot <br />Block <br />Division or Addition <br />Type Permit: <br />Remarks: <br />33680 <br />Utility Account No. <br />Connection Permit Fee <br />Connection Fee <br />Total Fee <br />Signed <br />Customer <br />Sewer District <br />Monthly Sewer <br />Monthly Sewer Constr. <br />Lateral <br />Abutting Lot Line <br />N, S, E, W__ <br />Approved By _ <br />City Enameer <br />Issued By -- <br />Inspection By—L� <br />Date Inspected % <br />/ <br />SEE SKETCH ATTACHED NO. 2 0 72 5 <br />