Laserfiche WebLink
everetl <br />� <br />City of Everett <br />Engineering & Community S��rvices <br />Sewer Applir,ation and Permit <br />' `/ i <br />N0. `�%O1� DATE �' � ' � <br />CHART N0. � <br />o-zr_� <br />�os��r� <br />C)-22-iS� <br />�� <br />ok <br />Service Address 3 y ��'���'�1 r`"�`'� Utility Account No. <br />ra� <br />Billing Addrass -� '� �'� � � "�' � — Permit Fee -� � <br />City, State, Zip� ''r�'�-� ^`"� `�y o'�'1 Connection Charge(s) <br />/ i �7 / '^� ". <br />l s � _i <br />Owner (MorEgagor) ��'� `�'� `�^ --�`-n 7'''' x,�r'.--+��f'otal Fee <br />. — <br />�7 v�' �'� ��✓', <br />Billing Name %%�"j'"'�-� <br />Connection <br />DESCRIPTION: � <br />Lot � � � ��" Biqck �� �s'— <br />Plat _ " �� /�` . `r=y`*� <br />Unplatted �escription <br />. � <br />.�;; :f' ... � �_. ''�y i <br />Signed - — <br />Customer <br />%: . <br />i <br />Sewer District <br />Monthly Sewer Service. <br />Monthly Sewer Constr. <br />Trunk <br />Lateral <br />Abutting Lot Line <br />N, S, E, W_ <br />e <br />SEE SN:ETCH ATTACHED <br />INSPECTION <br />: • <br />Approver,' By '`'i `./...�-�,-.-� c.,J-,.-._� <br />Ciry Engineer / <br />� r" ' ;:� "1? <br />� � <br />Issued By ���"�4"J <br />—'^ C <br />Inspection � � <br />� <br />Date Inspected_, Z� <br />,� ,_ _ „ <br />N 0. __ � � .� _L �� <br />