Laserfiche WebLink
� <br /> eNlre/t � . � � t j ,. , , F�- <br /> e -- � �� � <br /> City of Everett <br /> En*neerin' Dep�rtment <br /> Sewer Application and Permit <br /> 33�42 <br /> No. �0490 DATE ; — ''� ` I� <br /> Service Address % �17 •-'<' '-'i ' Utility Account No. --"— � <br /> „ <br /> Billing Address ' ' �' Connection Permit Fee ' � ��f" <br /> City,State, Zip ' � /• { � ' _ Connection Fee <br /> Owner (Mortgagor) "`%= � y � '=-='� � ' Total Fee - <br /> _ , , . ,:� <br /> , Billing Name '" <br /> Connection BY � �� ' %� �'r�'": ' '� <br /> � . <br /> Address i ' - �� %.•�"�J Signed <br /> Customer <br /> ' Phone 'i --'�S � — <br /> , DESCRIPTION: <br /> Lot �`�� <br /> Block � <br /> Division or Addition ' f� •l � ' <br /> Sewer District — <br /> Monthly Sewer Service <br /> Remarks: � "' <br /> Monthly Sewer Constr. <br /> Approved By _: . . .; , � - '. � <br /> 'Ciry Enginccr <br /> Issued By " <br /> Connection By � a • � ��+c�l� <br /> , Inspection By��—�l,m�i . � <br /> flate Inspected,_J— /7— 7N <br /> � <br /> SEE SKETCH ATTACHED � �� <br /> i�d�, r-cnon <br />