Laserfiche WebLink
i <br /> everett . <br /> � , � �/ � <br /> � � <br /> City of Everett <br /> Engineering Uepartment <br /> Sewer Application and Permit <br /> ;, ; �► t. (� <br /> N0. 20 � 33. DATE �.' i� _ <br /> Service Address - " Utility Account No. <br /> 8illing Address Connection Permit Fee <br /> City, State, Zip ' Connection Fee <br /> Owner (Mortgagor) Total Fee � <br /> Billing Name _ <br /> Connection By <br /> Address Signed <br /> Customer <br /> Phone _— <br /> DESCRIPTION: Sewer District — <br /> Lot <br /> Manthly Sewer Service_ <br /> Block ' � <br /> Division or Addition Montlily Sewer Constr. <br /> Tru nk <br /> Type Permit: � , -- <br /> Lateral <br /> Remarks: - <br /> , Abutting Lot Line <br /> � . N, S, E, W __ ft. <br /> „ , � <br /> � <br /> �7 � <br /> �°—�-�^C E l.c..c']R -�-� l ( � �-, <br /> �3 M� .f � 1� � ,�[19��. <br /> // Approved By�._ <br /> (/ City Engmccr <br /> Issued By _�___—_ <br /> Inspection By—__— <br /> _ _ Datelnspec[ed _—_____ <br /> u <br /> SEESKETCH ATTACHED N0. <br />