Laserfiche WebLink
' CHART NO.�L?•Z�►S <br /> ; everetf <br /> ; /�o s j�r0 <br /> , e <br /> � s-- ,.- � s- <br /> f City of Everett /��. _ <br /> � Engineering & Community Services +1L /J <br /> ���� <br /> • <br /> ' Sewer Application and Permit <br /> NO. � �' r' ; : l) DATE 1�,1 i '� _ <br /> , <br /> ServiceAddressi�`��—% f��`� <br /> Utility Accaunt No. <br /> � ,� <br /> Billing Address�' � • ��X.. 'X ��G :��� _ Permit Fee �• �—�-� <br /> City, State, 2ip �_'�' '- —'C%�=�.' t=' Connec[ion Charge(s) <br /> Owner (Mortgagor) K—t f''�T. ����.' �� Total Fee ✓1' —�� <br /> � BillingName % :;e.1 .�,-�� <br /> Cannection By c=-=�'v�� �. <br /> Address_ Signed , t' ..-C�� `J ':�'�LG <br /> , . ,� <br /> c�s m�� <br /> Phone �--f.�l� �'/ � .� <br /> DESCRIPTION: Sewer District <br /> Lot �� l Biock ��.• rL.` <br /> Plat_- �-.-�:- �-i' !-.� � i�it�� - °_, � ',, � Monthly Sewer Service <br /> Unplatted Description Monthly Sewer Constr. <br /> Type Permit: /� �f ,�. Trunk <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> � <br /> ( <br /> � <br /> ! <br /> Approved By � �'r/ <br /> _ City Engineer <br /> / �' <br /> Issued By �--�. .���l- �,��/.J/._� <br /> � Inspection By�QL���+�� � <br /> _ Date I nspected � ` �7 <br /> � e <br /> SEESKETCH ATTACHED NO. <br /> !fdSP[C i IOf�I <br /> I <br /> � <br />