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9621 BELMONT DR 2016-01-01 MF Import
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9621
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9621 BELMONT DR 2016-01-01 MF Import
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Last modified
5/21/2017 8:02:02 AM
Creation date
1/23/2017 12:28:01 PM
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Template:
Address Document
Street Name
BELMONT DR
Street Number
9621
Imported From Microfiche
Yes
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ever�rtt _ � , � � "j -; .,� �}, <br />..� _ � _ ���. T�" . <br />� � . <br />. <br />City of Everett <br />Engineering Department <br />Sewer Application and P�rmit <br />NO. �� (j �i' .,; f_� DATE <br />Service Address <br />Billing Address <br />City, State, Zip <br />Qwner (Mortgagor) - <br />Billing Name <br />Connection Bv _ <br />Phone <br />DESCRIPTION: <br />Lot <br />Block <br />Division or Ad:iition_ <br />Tvoe Permit: <br />Utility Account No. <br />Connection Permit F <br />Connection Fee_ <br />Total Fee <br />Signed <br />u <br />SEE SKETCH ATTACHED <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 />City EnBinecr <br />I SSU C(� <br />Inspection By ��� � '_ , � <br />Date I�spected___�Z zL 7y- L__ <br />NO. <br />_� <br />
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