Laserfiche WebLink
1 <br /> ���a <br /> p � ... <br /> O <br /> ��� . � <br /> ��� CHART N . i <br /> �,�� everett ��� I <br /> � '� I <br /> ��� e �, TO POSTINf_..�� z' q <br /> L'` 4 `� rt� Q !Y :'�� V _ �• }K '`l I <br /> '.��'.�yy� City of Everett = ;, �; a ; o y:; _, ;� �. <br /> VI .J Y� . 1 ' ^ �. ,` <br /> .l a� I' � N . N '� <br /> g�y Sewer App�c�tion �rid �e_,��t � <br /> ��in � � DATE � � � �� � tia n I <br /> No. 2800� <br /> Service Address •,,� <br /> __ Utillty Account No. <br /> Billing Address <br /> City,State,Zip <br /> Permit Fee $ <br /> Connectlon Charge <br /> Owner _ , <br /> Trunk $ ��n ee — <br /> ConnecNon by I <br /> Laleral a <br /> Address <br /> Total Conneclion Charge $ <br /> ' 1 Phone Ulilily Developmenl Fee <br /> ��' Water $ I <br /> Legal Descrlplion: <br /> ' ' Sewer S <br /> Lot <br /> ��/ Tolal Development Fee $ I <br /> Block <br /> i i Plal I <br /> � Sewer Bond Dlsirict <br /> Uiiplatled Desc�iptlon: <br /> ' Abutting Lot Line I <br /> ' n I <br /> N, S,E,W I <br /> �' Type ol Permlt tHr coon�ction Approved By � <br /> ' Issued By— <br /> � Remarks %" <br /> �' _ Customer Signature— � <br /> I IMPORTANTI I <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING �� ����� <br /> Inspection By � I <br /> CALL 259-8810 FOR INSPECTION Date Inspecled /`��� <br /> SEE SKETCH ATTACHED <br /> No. 28006 <br /> it•isr[ci�ioN �� <br />