Laserfiche WebLink
r <br /> everetl <br /> � � � _ � �"v <br /> City of Everett ���j ���� ��� '� <br /> � i <br /> Engineering Department � <br /> i <br /> Sewer Appincation and Permit <br /> � q <br /> � 2cj.. �x <br /> rvo. �-Q 0 5 3 *� DATE <br /> f=-ur2ert /�� _ <br /> Service Address � �b � Utility Account No. <br /> >-_. <br /> Billing Addres; Connection Permit Fee " <br /> City, State, Zip Connection Fee - <br /> / �,.� <br /> Owner (Mortgagor) I�AJc>D - Total Fee <br /> Billing Name <br /> Connection By ` ' -:� <br /> Address_ i,' � .t Signed '' '� <br /> Cus�omer <br /> Phone . > -� � `y��r' <br /> DESCRIPTION:� ! <br /> Lot •_ � l <br /> Block �� , <br /> Division or Addition ' L • % <br /> Sewer District_ <br /> Monthly Sewer Service <br /> Remarks: ,>_/ • � , , <br /> " Monthly Sewer Constr. <br /> .�7„�1-ts �.�,�J� - �" APProved By .. � � <br /> City En9inccr <br /> .�.c� D �o?Do $ . . • ( <br /> —y Issued By � <br /> � sr � <br /> — Connection By <br /> Inspection By � • � <br /> Date Inspected_L�tr/7i <br /> � <br /> SEESKETCH ATTACHED <br /> I,::,�=�:TI,;�� <br /> • <br />