Laserfiche WebLink
1 <br /> •. w � . �. ��9 � <br /> everett U-. ! �' 2� � � I <br /> e ��� �� � <br /> � Q r /� � <br /> ^�// l (.{ � <br /> t /�i Y r��1'I/ - . - , I <br /> City of Everett " � � � I <br /> Engineering Oepartment � <br /> Sewer Application and Permit <br /> 3zes7 <br /> -� . <br /> N0. �� � �,� 2 DATE _ �'�� � <br /> � <br /> Service Address �� ' � '" �� Utility Account No. N <br /> �.'% -- '� <br /> Billing Address ' � � Connection Permit Fee <br /> % �-v = ' ' Connection Fee ` '� ' ' • � <br /> City,State, Zip i <br /> ;� ` , - Total Fee �/ � J <br /> Owner (Mortgagor) - - ' — , <br /> Billing Name ' ' <br /> � r- . <br /> Connection By �.-- <br /> Address_ . '' �� Signed � � ., . � <br /> Customcr <br /> '4�/` ' ' <br /> Phone � � ` '' <br /> DESCRIPTION:, <br /> ,�� <br /> Lot , '::' . • <br /> _ . . _ :, ; � <br /> Block _ , .. . , �V+" <br /> Division or Addition ` ' ' `i ' =�''� <br /> Sewer District <br /> Vlonthly Sewer Service � °` <br /> Remarks: :ll/-�(�� � -� <br /> ' � , Monthly Sewer Constr. i r, :� � <br /> r r. ';i . C� ..=. �/ <br /> � � <br /> �c ��C.s�, `G. h�o..:,,�. �aE a1 u. -�' fl c APProved By , -; ; ., <br /> City Engineer � <br /> � ,C n �-^' Issued By - <br /> C'c�� <br /> Connection By <br /> Inspection By� '�'" � '-�'^t""—' <br /> Date I nspected ���''( �3 <br /> .� <br /> SEE SKETCH ATTACHED INSPECTION <br />