Laserfiche WebLink
� <br />everett <br />� ^ <br />City of Everett � <br />Engmeering Deparrment <br />Sewer i4ppli�a�i�n and ��rmit <br />N0. . DATE <br />Sen•ice Address Utility Account Nc <br />Billing Address _ Connection Permit <br />City, State, Zip_' `�'- � _ Connection Fee_ <br />Owner (Mortgagor) Total Fee <br />Billing Name <br />Connection By .. � <br />Phone <br />DESCRIPTION: <br />Lot _ <br />Block <br />Division or Add <br />Type Permit: <br />Remarkr ,. <br />SEE SKETCH ATTACHED <br />.�'' � ra � � _ �'�` <br />Signed <br />Customer <br />S�wer District <br />Ntonthly Sewer Service <br />Monthly Sewer Constr. <br />Trunk <br />Lateral <br />Abutting Lot Line <br />N, S, F, W_ <br />Approved By <br />Ciry Engineer <br />iti5tli'Cj Ejy_ __. .___ <br />Ins�i�ctiori k34-- --- <br />Date �nspected____ <br />