Laserfiche WebLink
everen � _ S� <br /> � �7 <br /> . �� .- <br /> e � �.� ��` � , . <br /> � f,� -�� <br /> •� . , <br /> City of Everett ;�r�/�) <br /> Engineering Department ' <br /> 5ewer Application and Permit ����1 <br /> Np, .L �) 2 6 4 ✓ DATE <br /> Service Address " ~ ' � � ' �" ` `� � •'- � Utility Account No. <br /> ^ J O <br /> Billing Address � Connection Permit Fee -� <br /> City, State, Zip ' '� F-' C ��y + �jr� Connection Fee <br /> Owner (Mortgagor) �' " =' ' ` ` " " r;� �1 �+=� ' '"fotal Fee <br /> Billiny Name <br /> Connection BY ' -=------ -- • __ . <br /> � ,.�c:.. _ i ,,..,� f �.+ ; <br /> • , , ri .� �r " `- ' - Signed ' � � • <br /> Ad[�feSS —�— Customer <br /> � . � _� �- i . / � . <br /> Phone � - <br /> DESCRIPTION: <br /> Lot <br /> Block <br /> Division or Addition �' � � `' F- � �- ' � ' �-' ' <br /> , .. -= i�� --: -,- Sewer District -- <br /> _--- Monthly Sewer Service <br /> Remarks: � - c � -: ,, �1-= i•, ,;�� ,j,, , ,; : <br /> Monthly Sewer Constr. <br /> .:P J .� .5"�LJ -f �do (S � � APProved By . , ti �I .�. yi <br /> J"l'��— Gry Engmccr <br /> �d'�'� Issued By <br /> �LL _� <br /> — Connecti�n 8y ------- ------ <br /> — ,O � �,.,��.� <br /> Inspection By <br /> , Da[e Inspected ��� % ���' <br /> . � <br /> E <br /> SEE SKETCH ATTACHED <br /> ,�_ <br />