Laserfiche WebLink
ever'ett I -Z ` ^% =% ' <br />; '� �,�,� 'r;'.. <br />e <br />City oF Everett <br />Engineering Uepartment <br />5ewer Application and Permit <br />NO. �'.'_ _ ;, � � DATE - <br />Service Address ' " '' _ <br />Billing Address <br />CitY, State, Zip .. `�:� i,� LL . I i. ..� 1 f <br />Owner (Mortgagor) -�!; � �� <br />Billing Name ' '' �= <br />Connection By ' ' - / ' -- - <br />Address `.^ � % � i_ . <br />' '� . <br />PhOf1C .—_' _. ___' _ . _ ' - __ _ <br />DESCRIPTION: <br />Lot __ — — <br />Division or Addition <br />; ,�; <br />:;. <br />Utility Account No._ � • <br />Connection Permit Fee . � ,� _ <br />Connection Fee �� Z-'" ��� • <br />Total Fec---.--_— --- — — <br />Siync�l _ <br />c �. r.im„�, <br />_�� <br />SEESKETCH ATTACHED <br />Se�ver Dislrict_.__ <br />Monthly Sewer Service <br />�9r� ' hly Sewer Co��;tr <br />Approv��d By_ <br />c�rv E��y�����,�� <br />� <br />� <br />Issued Bv i ' • — <br />Connection By <br />Inspection By �'_u -��-� <br />:' / �;'�? �/ <br />Datc Ins{icctud_ .._ �_/. "- - -' - ----- - - - — <br />