Laserfiche WebLink
. <br /> I <br /> I <br /> r <br />� <br /> I+ <br /> n•'�r^tt _ <br /> .�--z _ <br /> c• e_ ..r <br /> a� � '- <br /> M (� � <br /> I � <br /> City of Everett `- <br /> � <br /> Engineering Department <br /> Sewver Applicatios� �nd Per�i� � <br /> I � � �, c� � <br /> No. 20526 DATE <br /> Service Address <br /> � Utility Account No. �� <br /> U <br /> Billing Address Connection Permit Fee ��-�� <br /> l .� <br /> City,State, ZipL�"�%1��� � , ��� J Connection Fee <br /> o� <br /> Owner (Mortgagor) Total Fee /��' <br /> Billing Name�'Ar` <br /> r "/ � <br /> F . Connection BY 1�---�5 StP�/� ' 7" .U/� � ' I 21 �' �� <br /> ,, G � ,G�c�� f� <br /> Address�7/�.� 5✓- Z-7-'- Signed L t-�'�( L <br /> I , /f/v��• i+ Cu�o� <br /> Phone ��1=-��-�f <br /> DESCRIPTION: <br />� <br /> Lot i� ' �� <br /> Block �a � � _ /f�����/� <br /> Division or Addition_--�����--_-.--� !� <br /> Se�vcr District <br /> � <br /> Monthly Sewer Service <br /> � Remarks: ,' �����/-LT/O�1/ � — <br /> I; <br /> Monthly Sewer Constr. <br /> i 3 � 5 I�_� <br /> ., � �� � �J <br /> �.- - Approved By L �� <br /> __—�::._�..� _-fl�- "j ! Q� 9inccr <br /> i <br /> :r � � I r' Z , � <br /> � � �SSU@CI BY <br /> �;G <br /> �`" Connection By <br />; l - C�_L�// C',fj��l� � v� . � <br /> Inspection By <br /> . a r <br />� N� Datclnspecied <br />� <br /> - eVr �. '�� <br /> � <br /> �- ti� i� <br /> y� <' - <br /> SEE SKETCH ATTACHED <br /> C1;5T0;�.S'_R COP'i <br />