Laserfiche WebLink
Z <br />ewerett <br />City of Everett <br />Engineering Department <br />Sewer Application and Permit <br />NO. AO076 <br />DATE <br />Service Addres^ j : \ L>> <br />Billing Address <br />City, State, Zip <br />Owner (Mortgagor) / Y•�� / ! �����/�' / <br />Billing Name <br />Connection 6y <br />Address_ r <br />Phone <br />DESCRIPTION; - <br />Lot <br />Block JJ _ )> 1 <br />Division or Addition /� /`-��� rllr" eu <br />Remarks: IVI)1 -t- <br />Z s— <br />r7 <br />,j2429 <br />Utility Account No. <br />Connection Permit Fee 1 <br />Connection <br />Total <br />Signed <br />Customer <br />I <br />I <br />SEE SKETCH ATTACHED <br />INSPECTION <br />Sewer District <br />Monthly Sewer Service <br />Monthly Sewer Constr <br />Approved By l <br />Gay Engineer <br />Issued By _ 1 <br />Connection <br />Inspection By <br />Date Inspected �/ �� 1- 2-- <br />