Laserfiche WebLink
ev�relt ��5 d--���-• <br /> � � --- �- Z - ,5 � <br /> � <br /> City of Everett <br /> EnNnaerino Dep�rtment <br /> Sewe�r Application and Permit <br /> N0. 21 � � G DATE ! � �T <br /> Service Address � � , , Utilfty Account No. <br /> Billing Address Connection Permit Fee _ <br /> City,State, Zip' �� Connection Fee <br /> Owner (Mortgagorl- ' Total Fee � _ <br /> Bflling Name ' ' <br /> Connection By '-- � <br /> Address _ Signed <br /> cmromer <br /> Phone , , <br /> UESCRIPTION: Sewer District � ' <br /> Lot � <br /> Block Monthly Sewer Service <br /> Division or Additfon ' _Monthly Sewer Constr. <br /> Type Permft: Trunk <br /> Lateral <br /> Remarks: ' <br /> Abutting Lot Line <br /> _. N, S, E, W ft. <br /> Approved By ' <br /> Ciry Enpinsn <br /> ISSUCf� B�/ � <br /> i <br /> Inspection By <br /> � _ Date Inspected�/� 7��1 <br /> SEE SKETCH ATTACHED Np, `Z 1 � 7 E�j <br /> �.,i�u;ii��r� <br />