Laserfiche WebLink
everett <br />..� <br />City of Everett <br />Engineering Uepartment <br />,✓ — <br />� � ;; . _ --- <br />._ � <br />-� _, -� — � . � = <br />;=�-�'" -- , �- _ <br />Sewer Application and Permit <br />N0. 2089� DATE <br />i <br />Service Address � /-3 n <br />Billing Address <br />City, State, 7_ip <br />Owner (Mortgagor)_ <br />Billing Name_ <br />Connectior By <br />Phone <br />DESCRIPTION: <br />Lot <br />Block � <br />Division or Addition <br />Type Permit: <br />Utility Account Nc <br />Connection Permit <br />Connection Fee_ <br />Total Fee <br />Signed <br />Customer <br />SEE SKETCH ATTACHED <br />Sewer District <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Trunk <br />Abutting Lot Line <br />N, S, E, W. <br />Approved By_ <br />Ciry Engineer <br />Issued <br />Inspection By <br />`v .:_ <br />Date Inspected J _ � <br />N 0. �> ;�� C� Cl �) <br />� <br />