Laserfiche WebLink
everett <br />� <br />City of Everett <br />Engineering & Community Services <br />Sewer Application and Perrr�it <br />- ,Y <br />NO. � �'� � :� :� DATE � ' <-' <br />Service Address—_�r�-3 O ,;- ,.. _,- ,: � � �7/%,, <br />BillingAddress_ ��r"l.�' �l�r� .:-:;-�-..��%. !- <br />� ..:• : •; :� �'' <br />City, State, Zip � - -' �. !!`.G� %a -.' J `/ <br />� ...—T . <br />-,�, � <br />Owner (Mortgagoc) ' = ,t" : �� / �",' — ` <br />/ <br />Bilfing Name -':r-' :�� <br />CHART N0. �' � <br />�O S %�O <br />� -f 0 -j g <br />� <br />Utility Account N�. � "-�3t1 �' � /- O� <br />Permit Fee ��d Y <br />� yo <br />Connection Charge(s) �=.� �� �/ <br />/� 4 '.i— <br />Total Fee <br />Connection By - _. �--- �, <br />! �f� <br />.; j <br />Address Signed � � �' <',%'��i'�.E'� <br />.�� %' Customer ' <br />Phone � � �` y76 !� � <br />DESCRIPTION: Sewer District i :� %•- ! � <br />�ot Biock "�. <br />Plat Monthly Sewer Service %��. - i <br />Unpla+.ted Description �.%� ��/ .'•.: �-�.:�� Monthly Sewer Constr. <br />�� `, SEE SK[TCH ATTACHED <br />. li'�P6CTIOI`] <br />�1fK"'� % .? O <br />Lateral ����� � �� <br />Abutting Lot Line <br />N, S, E, W '� �/ �� ft. <br />i/ <br />Approved By' ��� ��L==-� <br />City En9ineer �,//, <br />. i. -"" /�' <br />Issued By r, , _,%,�_ , ,� <br />Inspection By�/ -GGl'il�co,- <br />Date Inspected��/7 / <br />,. - <br />NQ _ . `'�% <br />�{_ � S e� , +..;t <br />aA4� � ° �5:,��. s <br />