Laserfiche WebLink
. eyerett <br />'��i `� �`�-5 <br />.., <br />City of Everett <br />Engineering Uepartment <br />-��:�^ .3�y/�� �p.� <br />Sewer Appiication and Permit <br />NO. �ZOH51. DATE � _ , �_ ..1 <br />Service Address � � <br />Biiling Address '' ' <br />. '� ., . <br />City, State, Lip � <br />Owner (Mortgagor) ' % � <br />Billing Name '�,�! Z'��� — <br />_ , �T <br />Connection By , — � <br />� Phone <br />DESCRIPTION: � <br />Lot - `� �� � <br />� <br />Block � <br />Division or Addition t <br />Type Permit: ,' � , = , /�' <br />Remarks: „ <br />� � - <br />Utility Account No. — `" <br />i <br />Connection Permit Fee ' � �' ' ' ' t — <br />, <br />Connection Fee — "' "--' - - <br />Total Fee ' ._. <br />� <br />g ��� i. �� <br />Si ned . cascomer + � <br />$ewer District <br />Monthly Sewer Service <br />.__..._. _. __. _ <br />Monthly Sewer Constr. <br />_' _�._���a.�' <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />SEE SKETCH ATTACHED <br />INSPECTION <br />oved By.�• , r/,%":, <br />City Engineer <br />d By <br />=ction By <br />Inspected <br />No. 20851 <br />