Laserfiche WebLink
evergn <br /> � -i-- ; �,. -' ;% � ==� �, � <br /> � 26 � � , <br /> � <br /> City of Everett � ���'�� � <br /> Engineering Oepartment / ) f C(,. � <br /> Sewer Application and Permit <br /> JJ y`i � <br /> No. 20599 DATE <br /> Service Address Utility Account No. <br /> Billing Address Connection Permit Fee -' <br /> City, State, Zip Connection Fee <br /> Owner (Mortgagor) - _ Total Fee <br /> Billing Name <br /> }�y���� ,n 7 <br /> Connection By � " """ ,,,J i;�;,;'� _ ('C� , ���'v ' �'". ' � <br /> �.-- <br /> Address Signed Y1'l�in h -�.. 1_�,--e..r.vtn.i�.,u. <br /> Customer <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot Monthly Sewer Service <br /> Block <br /> Division or Addition_ Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: <br /> — Lateral <br /> Remarks: <br /> Abutting Lot Line _ <br /> N, S, E, W ft. <br /> . <br /> Y� %� " u� <br /> � I r <br /> o� �F �/s' � < � '�-' �'' �-°-�-E <br /> -�� Approved By <br /> . Ciry Enginccr <br /> Issued By <br /> Inspection By�c��-���*-�"� <br /> Date Inspected�2���Y <br /> n <br /> SEE SKETCH ATTACHED ND• n O `1 � q <br />