Laserfiche WebLink
everett <br />� <br />c�n� or e�e�ett <br />Engineering Department <br />Severer Appl�cation and Permi� <br />PJ G. DATE <br />Service Address__ <br />Billing Address_ <br />City, State, Zio_ <br />Owner (?lortgagor)_ <br />Billing Name__ <br />Connection By_ <br />Acdress _ <br />Phone_-- <br />DESCRIPTION: <br />Lot — <br />Black <br />Division or Addition <br />Tvpe Permit: <br />Utility Account No. <br />Connection Permit f <br />Connecti.+n Fee_ <br />Total Fee <br />_, e,; „ _. _ <br />. <br />Signed ___ ____ <br />CUSI(1111Cf <br />SEE SKETCH ATTACHED <br />Sewer District____._ <br />Monthly Sewer Service. <br />Monthly Sewer Constr. <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved By <br />Ciry Enpincer <br />Issued <br />Inspection 8y �'' -- ,� �- ��{� a� <br />Date Inspected�__�f—,7��i <br />NO. � � ` <br />