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4732 BLACK FOREST LN 2016-01-01 MF Import
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4732 BLACK FOREST LN 2016-01-01 MF Import
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Last modified
1/30/2017 7:05:26 AM
Creation date
1/30/2017 7:04:49 AM
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Template:
Address Document
Street Name
BLACK FOREST LN
Street Number
4732
Imported From Microfiche
Yes
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� <br /> I <br />� <br /> i <br /> e�cereit , � <br /> e � � � � �� �� _ - <br /> ;� n � ,� �, , <br /> ,„ 5r- � c �� �� .� � � � "�� � <br /> Q _�--_ <br /> City of Everett <br /> Engineering Department <br /> 7 ,� �i % ��6 � <br /> Sewer Application and Permit �� <br /> N0. , . :� DATE <br /> Service Address��: �L�l���27�7� �A.�/FUtility Account No. <br /> Billing Address Connection Permit Fee <br /> City,State, Zip Connection Fee <br /> Owner (Mortgagor) Total Fee <br /> Billing Name <br /> Connection By <br /> Address Signed <br /> customer <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot LL.L/�G ;�/ —Z�— rj Monthly Sewer Service <br /> Block <br /> Division or Addition Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: � <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> �A <br /> Approved By <br /> C�ty Engineer <br /> ISSUEd By <br /> Inspection By�� �_���� <br /> — ������ � <br /> __ Date I nspected 7 i <br /> � SEE SKETCH ATTACHED N0. 21 � O Fl � <br /> ,r�-:" _ i <br /> i <br />
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