Laserfiche WebLink
� <br /> �� <br /> everett � t— <br /> � /rr/_�� - _> � - ��� `, <br /> l , � � .� � ,� � <br /> City of Everett <br /> Engineering Department <br /> Sewer Ap�plication and Permit <br /> � zs �� <br /> rvo. �.0181 � DATE <br /> , , �, . _ -. - , � <br /> Service Address , � �'% , � 'i'' F��• Utility Account Na -� �' - ' � -% ' "� - ��' <br /> Billing Address �.�(� ? �,�- '!-���� � %� Connection Permit Fee <br /> � � <br /> City, State, Zip ' ' � ` "��� �r-�-r�`-+� Connection Fee " <br /> / . <br /> Owner (Mortgagor) L � " `,ii�'."i; `5 ' Total Fee _ <br /> Billing Name - ''� � <br /> Connection By - <br /> Address Signed - "> <br /> Cuslomer/ <br /> Phone "' <br /> DESCRIPTION: <br /> Lot �� <br /> Block rl IJ <br /> Division or Addition �- � <br /> Sewer District <br /> — ^ — <br /> Monthly Sewer Service ��- <br /> Remarks • , ,. <br /> _ <br /> Monthly Sewer Constr. - <br /> v "�-� ��'� �P„� s' � <br /> Approved By � - � �� <br /> Y�i /�nr s O � �..�� � c CitV Enginecr <br /> ti.lD O <br /> Issued By � <br /> Connection By <br /> Inspection By �/`�G ��'��^'-'' <br /> Date Inspected 3/�7�73 <br /> :ID <br /> SEESKETCH ATTACHED <br /> INSP[CIION <br />