Laserfiche WebLink
everetl <br />e <br />City of Everett <br />Engineering Department <br />,1 , _ <br />. `r��-\ <br />, ., - _, . <br />�� ._-_ <br />Sewer Application and Perrr�it <br />NO.�O4�i�� DATE _ _ <br />Service .address_' ' ' Utility Account No. <br />Billing Address Connection Permil Fee_ <br />City, State, Zip � Connection Fee <br />', <br />Owner (Mortgayor)_ <br />' ^ � Total Fee <br />Billing Name — <br />Connection By . - , 1 � <br />Address_=�� / '—�,,.,<<� i_ �� _ Signed' ' - <br />,:ji_ f';it I:L:�:.(.. . . <br />cuvo�* <br />Phone ' - <br />DESCRIPTION: <br />Lot ' - <br />Block — <br />Division or Addition � !' F r' L7 �" <<� <br />Sewer District <br />Monthly Sewer Servi�e <br />Remarks: � • ="'F^ f'/'%« <br />Monthly Sewer Constr <br />.t�7 <br />SEE SKETCH ATTACHED _, <br />, � .. <br />Approved By_ 'f' ' ` — <br />City Engmccr <br />I SSU CCJ <br />Cannection By— <br />Inspection By_ A�%���'�"'— <br />Date I nspected /�� � J' <br />