Laserfiche WebLink
everett <br />� <br />City of Everett <br />Engineering Department <br />/ ; <br />/ � ��� _ ��— <br />Sewer Application and Permit <br />No.'�OU°2 � <br />Service Address <br />Billing /�ddress <br />City, State, Zip <br />Owner (Mortgagor)_ <br />Billing Name <br />Connection Bv <br />Phone <br />DESCRIPTIOfJ: <br />Lot <br />Block <br />Division or Addition_ <br />DATE <br />, Utility Account No. <br />Connection Permit I <br />Connection Fee <br />Total Fee <br />Signed � ' <br />Cuswmer <br />SI=E SKETCH ATTACHED <br />� <br />Il•I ;I'i=i;Tl�ii�l <br />Sewer District <br />Monthly Sewer Service_ <br />Monthly Sewer Constr. <br />Approved By <br />Gty Enginecr <br />Issued By <br />Connection By <br />Inspection By � ��il��,.o a <br />�ate I nspected 12 —`{ — 7 Z- <br />ca w r �i <br />� <br />