Laserfiche WebLink
everett =- : „ � <br />_ _, . <br />e -.�_-. � l--� % ; <br />. ,. <br />�� � <br />City of Everett <br />Engineering Oepartment <br />Sewer Application and Permit <br />rvo.:.1043� <br />� <br />DATE " <br />Service Address � \ � ) <br />Billing Address <br />City, State, Zip � <br />Owner (Mortgayor) 1 <br />Billing Name - <br />Connection By � <br />Address_ ' ' ' l ' ' <br />Phone '-> ', ' � <br />DESCR!PTIO�: <br />Lot = ; � <br />Block <br />Division or Addivon •— "^ �-'L� i� r`1 "T <br />Utility Account No.. <br />Connection Permit F <br />Connection Fee_ <br />Totat Fee <br />�-- . r ',�� <br />Signed <br />c��s�o�„��� <br />SEE.$KETCH ATTACHED <br />INSPECTION <br />Sewer District �_ <br />Monthly Sewer Service -- <br />Monthly Sewer Constr. ' � ` _ <br />Approved By_ • �_ , '� � <br />Cily Engineer <br />Issued By ' <br />Connec[ion By— <br />Inspection By__ �C�L- -� �a�" — <br />Date I nspected ��f�� `� — <br />� <br />