Laserfiche WebLink
everen <br /> � ,) � � n i <br /> L .. . i� � �I:. ., � ' �;,f� .� <br /> City of Everett / ' � <br /> I <br /> Engineering Department <br /> Sewer Application and Permit <br /> � ��� � <br /> NO. �O 1 O �1 � DATE �' -"' � <br /> Service Address ��2--� Nn�� TnN Utility Accouni No. <br /> Billing Address Connection Permit Fee - '� <br /> City, State, Zip — Connection Fee <br /> � _': <br /> Owner �Mortgagor) Total Fee " <br /> Billing Name <br /> Connection By ' <br /> Address - • •Signed <br /> customer <br /> Phone , , , ,� , <br /> DESCRIPTION: <br /> Lot <br /> Block <br /> Division or Addition ' � �' � <br /> Sewer District <br /> fvionthly Sewer Service - <br /> Remarks: - <br /> Monthly Sewer Constr. <br /> /Ya__L�L'S� �S o - 7 <br /> _ � � Approved By ' <br /> City Eno�:�.:�r <br /> � .. . <br /> Issued By � � �� - <br /> Connection By _ <br /> Inspection By — <br /> Datelnspected <br /> 31 <br /> SEE SKF.TCH ATTACHED <br /> Il.�,�f'��.'i i��� . <br />