Laserfiche WebLink
evereK <br /> � <br /> -�. <br /> City of Evarett <br /> Engineering Department <br /> Sewer Application and Perrnit <br /> (} , <br /> .' - ,J ,J <br /> N0. '��J � �% ,_ DATE - <br /> Service Address -•'�• Utility Account No. <br /> Billing Address Connection Permit Fee — <br /> � ""'" Connection Fee — <br /> City, State, Zip " <br /> Owner (Mortgagor) Total Fee <br /> Billing Name - <br /> Connection By `���' <br /> Address = �' - Signed --- <br /> c�s�om�,� <br /> Phone —�--- — <br /> DFSCRIPTION: <br /> Lot <br /> Blocic <br /> Division or Addition v'' y <br /> Sewer District <br /> � � �� <br /> Monthly Sewer Service <br /> Remarks: / /� <br /> y�� �y Monthly Sewer Constr.�___ — <br /> i <br /> u "n �- .2� (::.4�-�.�7" � i�i'. C- <br /> Approved By_ <br /> . c�cv e�,���,��, <br /> ��"f�G � � �' 7��-�--� <br /> Issued Bv -- <br /> — Connection By— <br /> Inspection By� ���^� ��A � �a�^a�1 <br /> i <br /> _ • ; � , <br /> Date Inspected__`��� ": ' — — <br /> -�— - <br /> .7 <br /> SEE SKETCH ATTACHED <br />