Laserfiche WebLink
everett <br />� <br />City of Everett <br />i :, . r ,`. <br />q..r:t ;�,. <br />.....+e+:eiF.�'-... <br />Sew�er App►I�ca�ion and Permit <br />.. <br />.. <br />. .• _.: <br />Service Address , - <br />Billing Address <br />City, State, 2ip_.�.tK � <br />Owner (Mortgagor) <br />Billing �ame gm — <br />Connection By_?�, <br />Address_—�,� <br />Phone <br />DESCRIPTION: <br />Lot�_ Block <br />Plat �e <br />Unplatted Descrip[ion <br />Type Permit: <br />Remarks: <br />IMPORTAfJT! <br />CALL 7•800�424•5555 48•HOURS <br />PRIOR TO DIGGING <br />CALL 259-8811 FOA INSPECTION <br />SEE SKETCli ATTACH[D <br />uti�itv aceo�m No. <br />Permit Fee <br />Connection Charge(s) <br />Total Fee <br />litilitp Develppment <br />water 179.00 <br />sewer d71.00 <br />650.00 <br />Pcc Ord. 1171-9� <br />Signed <br />cusromer <br />SewerDistrict �i};^vrii, i:ii�'li �3�:�@iiS3I0� ,-Y"s;: <br />Monthly Sewer ServiE@��=Uu17 <br />!:� i43 f414.il1 <br />�c <br />Monthly Sewer Con�?d?� -� • }' <br />i1ECii ti_"1;,;:�] <br />Trunk PUi CN 1%lU• d <br />E:SRCN _.+.SQ <br />Lateral L' Si:Ui •�15.Ik) <br />44;'JWY !F��.l"��1 <br />Abutting Lot Line���;���;°�4 <br />N S E W4tti�h7: E0.1;0 ft. <br />u L( YL <br />.�iE'4�' :.id.�j <br />L'f10 I =110.00 <br />i i7S-5 :b ;6.Q0 <br />Approved By f'Hk:CI: 91��.:9.� <br />� 1 <br />Issued By <br />J <br />Inspection By—_���`� <br />Date I nspected 3� y� � <br />NO. 46092 <br />INSPECTION <br />