Laserfiche WebLink
, <br /> . _ ._ (� ��-�l, -Z� - c <br /> everett <br /> � - - - „ - . <br /> /- _; <br /> � -•' _ � <br /> �i'ry of Everett -- <br /> Engineering Department <br /> Sewer Application and Permit 3 z � s 8 <br /> NO. G-�,QOG � '� DATE ' `' J ' — <br /> Service Address � ' � - "� ' '��- " ' - ''�tility Account No. - J <br /> Billing Address ' — Connection Permit Fee ` `,� , _ ,, _ , <br /> �lq Connection Fee ' - `��` '"�� � <br /> City, State, Zip � <br /> pw�er (Mortgagor) - � - '� Total Fee <br /> Billing Name <br /> „ _ : � irF � . : ,� <br /> Connection By <br /> Address � / {� � " ' � ��- Signed Customer <br /> . � _ � � `1 <br /> Phone '—�— <br /> DESCRIPTION: <br /> Lat - ' ^C, <br /> Block � „ � _ � . J <br /> Division or Addition ���� <br /> Sewer District <br /> Monthly Sewer Service � „ r <br /> Remarks: •,�/ , ��. _ _ i.' - ,.� , � : _ �,, :. <br /> Monthly Sewer Constr. �� ' " = <br /> — . . '�r <.._ <br /> ; �, — T/C l • <br /> i. t <br /> / > <br /> �A��`� � ��� �7 G APPfOVed By � Ciry Engmecr - <br /> v � �-(+C` S o� �!�J/J��-�, � ' °�" Issued By I <br /> L�� _ <br /> �.�1 - .Q.°'.ti'"_' -- <br /> Connection By <br /> Inspection By 'Q'" �"" " '�� <br /> Date Inspected 1�/� y/� � ✓ <br /> :PI <br /> SEE SKETCH ATTACHED i_ ,;- . i ,,, <br />