Laserfiche WebLink
. <br /> eYerett CHART N0�"`z- �S '.�`��� <br /> /��� �G�-'�� <br /> e _ : <br /> ,� - � y-� � <br /> City of Everet4 //�—�• <br /> Engineering & Community Services • <br /> Sewer Application and Permit <br /> NO. r' � �l �; ',� DATE � 7 %?� <br /> Service Address ,�C��� � �. Cr i Utility Account No. <br /> BillingAddress �,� _, �/ � ;� J , � '-�'� <br /> Permit Fee lU <br /> Cit State, Zi �i` i- ,.�-------- <br /> Y� p— �' G'' Connection Charge(s) <br /> . � <br /> Owner (Mortgagor) : � % ' Total Fee <br /> Billing Name ,� <br /> Connection By �._-- <br /> Address <br /> Signed <br /> Phone � � �� - -; ��/�'� Customer <br /> DESCRIPTION: Sewer District <br /> Lot •� Block <br /> Plat /� !/• — Monthly Sewer Service - � <br /> Unplatted Description Monthly Sewer Constr. <br /> Type Permit: .- . — Trunk <br /> , , <br /> Lateral <br /> Remarks: i <br /> Abutting Lot Line . j <br /> � <br /> N� S� E� W ' ft. <br /> � Approved By- • i <br /> Ciry Engincer <br /> Issued By i _ / <br /> _ I <br /> � <br /> I <br /> Inspection B � I <br /> 3 Datelnspected_��'���z�_ i <br /> . <br /> SEESKETCH ATTACHED NO. � � <br /> �� P�-C Il('i; ; <br />