Laserfiche WebLink
.. _ _ __;-_ - . . <br /> everen C, 1_`'� " �`_� ` �'' / <br /> .. ' <br /> � � ._ � ��� � <br /> , � � � , ��:-�' <br /> >/i=��L, <br /> City of cverett <br /> Eopineering Department <br /> Sewer Application and Permit'� <br /> No. 21G56 DATE - , <br /> Service Address � � � � . 7/� -<" . , Utility Account No. <br /> Billing Address Connection Permit Fee <br /> _ _ <br /> City,State, Zip' Connection Fee � <br /> Owner (Mortgagor� - r .' � 'i�- � �' ,` Total Fee ' <br /> Billing Name <br /> , -. <br /> Connection By � • ' <br /> Address Signed — <br /> Customer <br /> Phone <br /> DcSCRIPTION: Sewer District ' �% — <br /> Lot <br /> Monthly Sewer Service <br /> Block <br /> Division or Addition Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: i' ' <br /> Lateral <br /> Remarks: �� <br /> �i� 95 F�.�' S.Y6T�'f/• Abutting Lot Line <br /> N, S, E, W it. <br /> Approved By_ -- <br /> Ciry Engineer <br /> Issued By <br /> � � <br /> Inspection By <br /> Date I nspected �—�� -- �5 <br /> e <br /> SEE SKETCH ATTACHED N0. ;% i (1 j � <br />