Laserfiche WebLink
I* - <br />City of Everett <br />Engineering Department <br />X J-7-29 5 .s <br />�D 5� jL�' �f4 <br />Sewer Application and Permit <br />NO. 21058 DATE ! - <br />Service Address / 7/ , <br />Billing Address 7, % r <br />City, State, Zip — <br />Owner (Mortgagor) <br />Billing Name <br />Connection By <br />Phone <br />DESCRIPTION: <br />Lot <br />Block <br />Division or Addition <br />Type Permit: <br />Remarks: <br />10 <br />0 <br />._ ` n <br />SEE SKETCH ATTACHED <br />INSPECTION <br />Utility Account No._ <br />Connection Permit Fee <br />Connection Fee <br />Total Fee <br />Signed <br />Customer <br />Sewer District <br />Monthly Sewer Service. <br />Monthly Sewer Constr. <br />Trunk <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved By_ <br />CityEngineer <br />Issued B <br />Inspection By C- bt R-' t"'I <br />Date Inspected - <br />No. 21058 <br />