Laserfiche WebLink
everen <br />� <br />City of Everett <br />Engineering Oepartment <br />Sewer Application and Permit <br />N0. �' DATE <br />Service Address_ _ <br />Billing Hddress <br />City, Stab:, 7ip <br />Owner (Mortgagor)_.__. <br />Billing Name <br />Connection By_� <br />Address <br />Phone._.— — <br />DESCRIPTION: <br />Lot �—_ <br />Biock <br />Divisiun or Addi:ion <br />Type Permit: <br />Utility Account N��„ <br />Connection Pf:rnit F <br />Connection Fee_ <br />Total Fee ___ <br />Signed <br />customer <br />Q <br />SEE SKETCH ATTACHFD <br />Sewer District____ <br />Monthly Sewer Service_ <br />Monthly Sewer Constr. <br />Trunk _ _ <br />Lateral _ <br />Abutti�g Lot Line <br />N,S,E,W <br />Approved By <br />Ciiy Engmeer <br />�SSUCC� B <br />�i <br />, �y---,— <br />Inspection B ` � % -� � �- --- <br />Date Inspected__ ���. ��y � __ ___ <br />N0. <br />