Laserfiche WebLink
e4eret[ `� <br />� <br />City of Everett <br />Engineering Department <br />'�, � ,J� <br />.�, � /��,. _ �� <br />/; __-`' <br />� -7- z�'s ���'...03i <br />Sewer Application and P�ermit <br />;., ; -1 <br />N0. 2Q%92 DATE .. - <br />ServiceAddress i� ��%i� i�vi �f'i'„s��'/��`/ -L�1�°;� UtilityAccountNo. �_T_, - <br />Billing Address �°�%1'�l� Connection Permit Fee -�-1 ��� � ' ��� � <br />, <br />City, State, Zip-` �iFr%�.i"%� %/Jf:� .��r,-, , Connection Fee � � —� <br />Owner (Mortgagor) %—i/ � ,.-t ' .. i � Total Fee �� =. ,�,'' �') <br />Billing Name - �'/ ,I.�:;: r�', �' <br />' , ,: , � ., . <br />Connection By iYE, .'� ,1 �,: ,/,: �' „ <br />Address.�'1.i''_,fl_.j�.`.�G"% `/). , _,��; <br />Phone ��i" `�'i/ r , � ; / � , <br />�'_ , � _- <br />;-.,>>. — �, <br />Signed ' �' ; " u J i -_ <br />Customer <br />DESCRIPTION: Sewer District �l� `��i• / 1- <br />Lot <br />Block Monthly Sewer Service <br />Division or Addition'��%'''�r/% � -- :.i � � � MonthlySewerConstr. <br />SEESKETCH ATTACHED <br />Trunk_ <br />Lateral , �: T <br />Abutting Lot Line <br />N, S, E; VII� %�%'� ft. <br />Approved By ; .' r� ��,�'i,ri � - <br />City Engineer � <br />;i <br />Issued By. ' . • _ <br />Inspection By �'% <br />Date Inspected /�/�y <br />NO. :-;r���n <br />� <br />