Laserfiche WebLink
s <br />��i�erett <br />� <br />�._� <br />City of Everett <br />Engineering Department <br />_ � /' J <br />� �' � ��� �� , „ <br />'' �� % � 1 <br />/i;`''. <br />! <br />��wer A�piicatian �nd Permi� <br />N0. c�Q��J� <br />� r"_ <br />Service Address � <br />Billing Address <br />City, State, Zip_ <br />Owner �Mortgagor)__ <br />Billing Name <br />Con�ection Bv_ <br />Phone <br />DESCRIPTION: <br />Lo± ! <br />� �� <br />Block <br />Division or Addition_ <br />Type Hermit. <br />DATE <br />34Ur�;� <br />Utility Account No. <br />Connection Permit F <br />— Connection Fee <br />� — <br />i <br />� � ��� Total Fee _ <br />� — <br />Signed <br />Cus�omer <br />SEE SKETCH ATTACHED <br />Sewer District <br />Monthly Seti•_r Service, <br />Monthly Sewer Censtr. <br />Trunk <br />Abutting Lot Line <br />N, S, E, �V <br />Approved By_ <br />City Engineci <br />Issued B <br />� / <br />In�pection By � , �-td � <br />�rite Inspected S - l3 � 7 � � <br />N0. �,r� <br />