Laserfiche WebLink
everett I <br /> i I <br /> � � � �� � � , � <br /> I <br /> Cib� of Everett ' I <br /> En�ineering Department <br /> i <br /> Sewer �pplication c�nd Permi� ��- <br /> N0. ,-�� 'J �:, .- . DATE � � '_ � -- — <br /> Service Address . '}''. Utility Account No. <br /> � i <br /> Billing Address — Connection Permit Fee <br /> City, State, Zip ` � - ' Connection Fee <br /> Owner (Mortgagor` � ' Total Fee <br /> Billing Name <br /> Connection By � % ' ' <br /> Address `� �' � � Signed <br /> CustOmer <br /> Phone_ — <br /> DESCRIPTION: <br /> Lot �' <br /> Block �11 <br /> Division or Addition - - '�� <br /> Sewer District _ -- <br /> � <br /> —. Monthly Sewer Service � -- <br /> Remarks: �: �"%..� L / ��-� <br /> — Cy Monthly Sewer Constr. � — <br /> f <br /> l '� Ce�-.-�.., r r ' '_�-,c���- t�r�.Z` ��iu_o-.....�. <br /> �� ApProved BY — <br /> ' .Ciry Enginecr <br /> � ,/ �GCS� �-�a ��.�-J-cn � G�.�.� �Q.�.r Issued By--- -- <br /> -- Connec:ion By—_ — -- <br /> � � __ <br /> - Inspection 9Y—=,�l�t'�'�'.""``-`� — <br /> Date I nspecteG__�� . ��` ���—_ <br /> � - — -- <br /> SEE Sf<ETCH ATTACHED <br />