Laserfiche WebLink
rir <br />everc-r <br />e <br />City of Everett <br />Engineering & Community Services <br />Se�nrer Application and Permit <br />N0. F � :� �_) I_J .� DATE _/D _ /,r, <br />CHART NO.� �� 1t�T_ <br />/�o s %L=D �j <br />Service Address - � -' ' <./. �t.+ :� a iL t' ;'� �`i 6 JUtility Account No. � - <br />Billing Address���l1 •�7 �- •<'/i' / .�� •:' << ^'ic Permit Fee ' �� <br />City, State, Zip �'t �/%' / � � i" , .I / : %% Connection Charge(s�_ <br />Uwner (Mortgagor) %i ,.: /"_.�_7 - '',: '� -,'.,� Total Fee " J <br />Bi!;ing Name --� A c� ;- <br />Connection By � � '� r '� <br />Signed <br />Phone- � - ✓/ /� <br />DESCRIPTION: � � • <br />Lot � Block / <br />Plat <br />Unplatted Description <br />. � <br />� G � � y� �p�. <br />�<,.'��. � ��' �4i- ;a!'_, a <br />' '.� _r���' <br />Sewer District � i� <br />Monthly Sewer Service '� �� <br />Monthly Sewer Constr. <br />Trunk �- /�� <br />Lateral . : <br />Abutting Lot Line <br />N, S, E, W, <br />Approved By' <br />Gry Engmeer <br />Issued By <br /><; �� <br />. . <br />�. • .• •. <br />• <br />� �;��.� � ��...� i a li'::.� <br />H• ��f i y,1,. <br />�'1�<< r �aj��•:s"�-_ <br />