Laserfiche WebLink
evcre� � � <br /> � <br /> e � ���� � �� � � <br /> � - � <br /> C <br /> City of Everett <br /> Engineering Department � <br /> Sewe� Application and Permit <br /> ��� :a � <br /> N0. .- ..' �� .: DATE — <br /> Service Address Utility Account No. -`" <br /> Biiling Address �<_- Connection Permit Fee � <br /> City, State, Zip Connection Fee " � <br /> � C.��. �� - - � <br /> Cwner (Mortgagor) ��L1��-'- „_ Total Fee_ <br /> Billing Name <' <br /> Connection By ' ' ' ` � - <br /> Address _ , ' �` Siyncd <br /> c��,���„�„ <br /> Phone <br /> DESCRIPTION: <br /> Lot <br /> Block � <br /> Division or Addition -`� "-r f� T ,� � ' <br /> Sewer Dist ict <br /> Monthly Sewer Service � <br /> Remarks: ` — �; - r� <br /> Monthly Sewer Constr. <br /> '1 :ti�.a .�c���t�. <br /> ^ n . -} � f� ! Approved By <br /> �yyy�ii.. .t.J�a W-�-�--C '�/.li (t/.t/1 I.tJ�W l 110 Ci�V Engineer <br /> � <br /> Issued By <br /> �t n� ��-�..i I � . <br /> Connection By <br /> � a�--.uc+.� � n <br /> Inspection By '��(��1'�� <br /> Date Inspected 9'/-i�/�3 <br /> -- ---- - — <br /> � <br /> SEE SKCTCH ATT.4CHED <br />