Laserfiche WebLink
�. /LG'�— <br /> „ CHART Nf�.�--�=�� — <br /> ' everen I �Q g "%.s +�' �• , <br /> � e <br /> City of Everett <br /> Engineering & Community Services <br /> � Sewer Application and Permit <br /> ` �-- <br /> jr? �) ? �.�i ` DATE .,� - �'� -_ i /� -- .�----------- <br /> i No. � . �, :: J <br /> � :� � �� 3 � �:i <br /> �� j ,/� i %j ! ;t /'_ i��- T �Jtility Account No. % <br /> ( Service Address y;r <br /> � :,/:�;"/ /(i_' , T Permit Fee <br /> � Billiny Address�� 1�---- =- <br /> (J <br /> t b,v v 3- cG ') 't�•� � � - Connection Charge�s)__ — <br /> I City, State, Zip <br /> I Owner (MortgagorY� � f-�' � ' ��� ' % '�"'`�� • Total Fee - <br /> I <br /> � Billing Name `"� <br /> ( �� �� �� : <br /> Connection By �:) • % _;:;,,; � <br /> i _— — Signed / i � . 'b_;< � , . . <br /> Address c"��°"�` <br /> I % /-z � �� XlY -- IL <br /> i Phone -. — <br /> DESCRIPTION: Sewer District � � � <br /> j Lo[ -� � _ Block—�-- - Monthly Sewer Service____-------?�--- <br /> i Plat s�/ � ! i `-'�- — <br /> Monthly Sewer Constr. <br /> Unpl:rtted Description <br /> I � ' Trunk — —��=� -- <br /> � Type Permit: . �' ' Late�al <br /> �--- <br /> � - -- — <br /> 1 <br /> Remarks: Aliutting Lot Line <br /> � N r� E W — �� —tc. <br /> I ------ <br /> i - � <br /> I __ Approved BY' ' <br /> GW Engineer <br /> � �----__—_--_ r <br /> I <br /> I __'" '�_-- �Stil18f� QV—_'_'__' .—�_..--.--- <br /> i <br /> � �. <br /> ' — ,(�1'�7����=. - - <br /> � � �ns{�ecllon sy— - . ... <br /> � / /�--1� <br /> ! Dateinspected_—. _ —<-- ._ <br /> ; o— -- N0. <br /> � SEE SKETCH A`TACHED <br />