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r <br />e..eteS <br />City of Everett <br />Engineering Department <br />Sewer Application and Permit <br />NO. 20814 DATE <br />Service Address_ i <br />BillingAddrees. /4/t/6. <br />City, State, Zip. , L C Z/_ T <br />Owner (Mortgagor) <br />Billing Name -+ <br />Connection By / <br />Address / . / r/ <br />Phone__ C - <br />DESCRIPTION <br />Lot <br />Block -- <br />Division or Addition <br />Type Permit: <br />Remarks: <br />SEE SKETCH ATTACHED <br />Utility Account No. 33s- eo <br />Connection Permit F <br />Connection <br />Total <br />Signed <br />CUflonwr <br />Sewer District <br />Monthly Sewer Service_ <br />Monthly Sewer Constr. <br />Trunk- <br />Lateral - <br />Abutting Lot Line <br />N, S, E, W <br />Approved By <br />Cily E.V..ecr <br />Issued <br />Inspection By_� �DZ( <br />Date Inspected_// <br />NO. ' <br />---ft. <br />.L71111,16L■L <br />