Laserfiche WebLink
everett <br />� <br />City of Everett <br />Engineerin� Department <br />Se�rver p►pp►�iccation and Perrnit <br />,., , <br />n, o. � 1 �! �:� : <br />Service Address_ <br />Billing Address_ <br />DATE <br />Utility Account No: <br />Connection Permit <br />City, State, Zip Connection <br />Owner (Mortgagor) Total Fee_ <br />Billing <br />Connection B <br />i,� ,� �l;;r�' �t � <br />r� _ � <br />a v ,,� p /F� w . <br />.:�•-- <br />n',� 0�1i 6C� �.- �' <br />. . r '� <br />iCoC Z <br />Signed <br />Customer <br />DESCRIPTION: Sewer District <br />Lot "� -7 <br />Block / Monthly Sewer Service <br />Division or Addition�[�/ .• �� �� �� Monthly Sewer Constr. <br />� <br />Type Permit: <br />SEESKETCH ATTACHED <br />IN�.'.� ,_r�i�ir�;; <br />Latera <br />Abutting Lot Line <br />N,S,E,6V. <br />Approved By <br />City EnBineer <br />Issued <br />Inspection <br />Date <br />rvo. i j, ri � 1 <br />