Laserfiche WebLink
� � <br /> everett CHART NO. � — � � <br /> ; Q i— •1 q -�°f- ,y_' <br /> � _., <br /> ; /�o S �� � i io-� ': <br /> t City of Everett <br /> i <br /> � Engineering & Community Services <br /> ` Sewer Applicatian and Permit <br /> , <br /> - .' 'f, j�. <br /> N0. E: .� I �, t, DATE <br /> Service Address -' ��� `i C- :Y�A .�' r Utility Account No. <br /> Billing Address�� �a � r�; 5� Permit Fee ��� J <br /> � City, State, Zip /u +'/ /� / 1 % ;?� U l-vA Connection Charge�s) <br /> f� t <br /> Owner (Mortgagor)�%i, Y//) .1 . '" ( �I �� :1 y'.! h Total Fee yC � � <br /> Billing Name � � ti� r <br /> Connectior; Byf1� v/v ,�) �,<" .� ,^' /� ✓v: ,� <br /> Address P ��. ��oi�' y'=r4� Signed _ -�_ <br /> Cunomer i <br /> Phone % ` �' /� .� �' �� <br /> DESCRIPTION: Sewer District /�'''% � % c �,�/ <br /> Lot / ^ � Block � - > <br /> Plat r ✓ �` ' T J? Monthly Sewer Service �'� < � � � �� <br /> Unplatted Description Monthly Sewer Constr. <br /> Type Permit: �,. �- i;;� L�U � f� �' y � � Trunk. <br /> , i ,� i �, /z ��_� Lateral <br /> J <br /> Remarks: . / <br /> Abutting Lot Line <br /> _ N, S, E, W ft. <br /> APProved By r'a' _ <br /> City Eng;neer <br /> i <br /> r <br /> Issued By_�— � - f <br /> ,�jJ� r <br /> � Inspection By__�ti'��••.•—' <br /> i '�/ <br /> i Q __ " —� Date I nspected_1T1�'7�7 7 <br /> l \ / <br /> SEESKETCH ATTACHED-/ NO. , . <br /> � _- , - If;SPtCT10�1 � <br /> �< . <br />