Laserfiche WebLink
everPtt <br />� <br />City of Everett <br />�ngineerinp Uepartment <br />Sewer Application and Permit <br />NO. i .' .I � �� E; DATE <br />Service Address <br />Billing Address <br />City, State, Zip <br />Owner (Mortgagor� <br />Billing Name <br />C�nnection By <br />Address _ . � ' ' % . <br />Pho�,:• <br />DESCRIPTION: <br />Lot <br />B ck <br />Division or Addition_ _ <br />Tvoe Pernit: <br />Utility Account No. <br />Connection Permit f <br />Connection Fee_ <br />Total Fee <br />Signed __ <br />Custamer <br />SEESKETCH ATTACHED <br />''.-r'-!�li',�-. <br />Sewer District <br />Monthlv Sewer Service <br />Mon!hly Sewer Constr. <br />Lateral <br />Abutting ! ot Line <br />N, S, E, W_ <br />Approved By <br />Ciry Enginccr <br />Issued <br />�4 <br />� <br />Inspection By---.�� � _ <br />�ate Inspected %! .�O <br />N0. �'11c. <br />,_ � � ._ <br />