Laserfiche WebLink
everett <br />e <br />City of Everett <br />Enpineering Department <br />� <br />fl ___"'f,s��" <br />�^-�d„�r� AL.;,.. <br />�` r <br />:� ''�rz' Q—s' <br />Sewer Application and Permit <br />NO. ! L�=C� ;' DATE �'-'�%���-- <br />i " <br />Service Address % � Utility Account <br />Billing Address <br />City, State, Zip <br />Owner (Mortgagor) <br />Billing Name <br />Connection BV <br />Phone � � <br />Connection Permit <br />Connection <br />Total <br />Signed <br />Cusromer <br />DESCRIPTION: Sewer Oistrict <br />Lot <br />Block_ Monthly Sewer Service <br />Division or Addition � Monthly Sewer �:onstr. <br />Type Permit: <br />SEE SKETCH A'iTACHED <br />ir:s�tCrior�i <br />Trunk <br />Latera <br />Abutting Lot Line <br />N, S, E, W ft. <br />Approved By <br />City Eneineer <br />Issued <br />Inspection By ����� ' <br />Date Inspecte ��/�b <br />No. 21507 <br />