Laserfiche WebLink
� <br /> � <br /> � <br /> i <br /> i' <br /> � <br /> everetl <br /> e � JP� � ��� _ . <br /> City of Everett � � a-� ' �� <br /> Engineering Oepartment <br /> Sewer Application and Permit <br /> ✓ <br /> 3�::91 <br /> NO. �.O .L J J DATE _..-- _. . <br /> a �o Z �n�i3r � — <br /> Service Address ---���! Utility Account No. - � <br /> -z, <br /> Billing Address Connection Permit Fee <br /> � , <br /> City, State, Zip_ �" i � / %Connection Fee <br /> Owner (Mortgagor) =�� Total Fee %"" <br /> Billing Name_ <br /> Connection By - <br /> Address - -;.�%- � �� <br /> Signed <br /> �. � . . %� t � � ' � Customcr <br /> Phone— �� .} f ��. <br /> DESCRIPTION: <br /> Loi <br /> Blocl� y r <br /> Division or Addition�_ _ .^ > -' ,��� <br /> Sewer District <br /> Remarks: �._- ,,�, ,,., <br /> Monthly Sewer Service <br /> Monthly Sewer Constr. <br /> u �� cu �e- - S�� ,{ m '/- t� 20l1-1 <br /> /� Approved By <br /> ,�0 �S/� ��� l/z`.-7(� C�ty Engin�:er <br /> � <br /> 'eM Issued By <br /> Connection By <br /> Inspection By <br /> Date Inspected <br /> :e <br /> SEE SKETCH ATTACHED <br /> Ii ISPCCTION <br /> `' � - -- � . ;�; <br /> � _....,., <br /> :+++-. �� <br /> '� �*.-. <br /> �,.;.a <br />� <br />