Laserfiche WebLink
��� <br />C � <br />��r� <br />�a�� <br />� <br />s <br />o�� <br />��8 <br />�!�Y � <br />H <br />� H <br />Q�N <br />f �W <br />�O� <br />�r� <br />A <br />everett <br />� <br />City of Everett <br />Sewer Applicat <br />No.28683 <br />m <br />� <br />� <br />� � s� <br />� �.�z a `� <br />ivn `�� �ermit <br />�� �" O <br />� ���iX�u <br />DATE S�S�9z <br />Service Address _ _9�2EL.Bearasly.�.�— <br />BIIIing Address <br />Clty, Slate, Zip Evaretc NA an�n1 _ <br />Owner " 3s�8 ' � <br />Connectfon by _ <br />Address <br />Phone <br />Legal Descrfpilon: <br />Lot <br />Block <br />Plat <br />Unplatted Description: <br />Type of Petmll •�ex Connectf.o <br />Remarks <br />IMPORTANTf <br />CALL 1-800-424-5555 48-HOURS <br />PRIOR TO DIGGiNG <br />CALL 259-8810 FOR INSPECTION <br />SEE SKETCH ATiACHED <br />Utility Account No. <br />N0. — <br />TO POSTING��'Z_ �_Q,= <br />Permit Fee $ <br />Cannection Charge <br />Trunk $ <br />Lateral $ <br />Total Connection Charge $ <br />Utility Development Fee <br />Wator $ <br />Sewer $ <br />Total Devetopment Fee S <br />Sewer Band District <br />Abutting Lot Line <br />N, S, E, W � <br />Appro�ad By .— <br />Issued By — <br />Customer Signature <br />Inspeclion Fiy _ <br />Date inspected <br />wsr�ECTion <br />�O��c��rc.�i�� <br />�- Sl-� � <br />00 <br />No. 28683 <br />