Laserfiche WebLink
. .,�� <br />evereh <br />e <br />City of Everett <br />Engineering Dep�rtment <br />� <br />f ' � L % <br />��: <br />�� ��� .. <br />�=>>- `, :. <br />� �.; �� �, . <br />Sewer Application and Permit <br />NO. DATE "S �' �%_ 1 — <br />i <br />Service Address Utility Account No. <br />Billing Address_ ' Connection Permit f <br />City, State, Zip � �\� Connection Fee <br />Owner (Mortgagor) � Total Fee <br />Billing Name <br />Connection Bv_ <br />Signed <br />Custnmer <br />Phone <br />DESCRIPTION: <br />Lot <br />Block � <br />Division or Addition <br />0 <br />SEE SKETCH ATTACHED <br />Sewer District <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Approv�d By <br />Ciiy Engineer <br />I SSU B(� <br />Connection By r t� _ , <br />Inspection By <br />]ate Inspected <br />