Laserfiche WebLink
, <br /> everett <br /> CHART N0. K J C �z i' ' y <br /> � � ' <br /> c�s��/� <br /> Ciry of Everett �� �/�' � ��� <br /> n JEngineering & Community Services ' <br /> � <br /> Sewer Application and Permit �-� <br /> � ;� <br /> N0. ;� t' �'� � :� DATE i .:. �. J : <br /> Service Address L ,> .� :� a:T ,, ;i.`. <br /> Utility Account No. <br /> BillingAddress �'�' z S 'J �- -"� -- �' �� Permit Fee �� "" <br /> City, State, Zip . '�%t� ,'��.,.1 'J � %� " Connection Charge(s) <br /> rf / :, <br /> , <br /> Owner (Mortgagor)_�f -�-l1-�� % �'-�� � Total Fee �- ' <br /> Billing Name :��'c- � , �7 — <br /> � <br /> Connection By <br /> Address Signed �'�� • �.. :,G( ��� � � • < <br /> Cusromer <br /> Phone <br /> DESCRIPTION: Sewer District j �- ' �`' � .i <br /> Lot �=' Btock � <br /> Plat { �� -� / - � . :�.�i`�,- .' Monthly Sewer Service <br /> Unplatted Description Monthly Sewer Constr. <br /> Type Permit: Trunk <br /> ir . <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> � <br /> N, S, E, W ft. � <br /> I' <br /> APProved By , _ '.�i., _.-,.,..- <br /> Ciry Engincer • � <br /> � «� "./ �. <br /> Issued By > ('='�r :" <br /> — ( . _.� I <br /> Inspec[ion By � <br /> i <br /> Datelnspected_ � <br /> ° 1SEE SKETCH ATTACHED N0. <br /> I�JSPECTION � <br />