Laserfiche WebLink
everett CHART NO. � � � �� ' <br /> ,l�e 1 Tt�"� <br /> �j � 2, 3 — 7g' <br /> S <br /> City of Everett ,^�'" _ <br /> Engineering & Community Services <br /> Sewer Application and Permit <br /> NO. � � 17 � DATE �- /'' _ �X — <br /> --� - <br /> Service Address r��'� - " � -� _'` =- = --� Utility Account No. j' J > - =�' � -`" '� <br /> u S-� <br /> Billing Address"=�Q - •. -'. � .-: �� 7 Permit Fee.— 1 � <br /> c.'' -�. / E�- <br /> City, State, Zi�,�. 1"-�, :'U�c - �k ,-- U j Connection Charge�s) �U `� <br /> •y�r <br /> Owner (Mortgagor) l�,��- � � �=l �- _� Total Fee �� <br /> BillingName %:�-.--•--�--' <br /> Connec?ion By /% �� <br /> Address Signed -r�./'� %�/.r./�. <br /> ! ' Cus�omer <br /> Phone � :j _ 4. <;� Q _ <br /> DES(:RIPTION: Sewer District -3 _��" , / � <br /> Lot_ -=� � Block� � -U <br /> Plat -✓'-�'1�; � - :.�.H- -% - Monthly Sewer Service ' � <br /> Unplatted Description Monthly Sewer Constr. ' <br /> � Type Permit: l� .- ' _ <br /> J� Trunk �� • K U <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> f �_ / . <br /> � Approved By - • " <br /> City Enninecr <br /> , � i: <br /> Issued By ' - <br /> r <br /> Inspection By� . �--_- - <br /> � Date I nspected '�/>/7 � <br /> I ' / <br /> SEE SKETCH ATTACHED N0. ,` <br /> ' I f�!�P EC110 f�l <br /> r <br /> I <br /> � <br />