Laserfiche WebLink
� <br /> , <br /> �everett _ / -, 1_ ._ _ I <br /> � �} �S►�.D ���=.:i� ;1 �.–.:;__ <br /> j\�..7_i�-- ?'; . <br /> City of Everett <br /> Engineering Oepartm�nt rn • <br /> Sewer App�ication and Permit <br /> NO. 2 11� 8 Z DATE <br /> Service Address Utility Account No. <br /> Billing Address _ Connection Permit Fee_ _ <br /> City, State, Zip_ Connection Fee <br /> Owner (Mortgagor) _ Total Fee _ � <br /> Billing Name <br /> Connection By <br /> Address Signed <br /> Customer <br /> Phone <br /> DESCRIPTION: Sewer District <br />• Lot <br /> Block Monthly Sewer SPrvice <br /> Division or Addition Monthly Sewer Constr. <br /> Trunk <br /> Typa Permit: <br /> Lateral <br /> Remerks: <br /> Abutting Lot Line <br /> O� �–ZZ-7� !✓ N, S, E, W_ _ft. <br /> Approved By_._ <br /> Ciry Engineer <br />; — Issued By_ <br /> I <br /> Inspection By� ' � ' <br /> Datelnspected ,���–%r U _ <br /> 0 <br /> S[E SKETCH ATTACHED N0. ;-� I_ �I ;�; ,% <br />