Laserfiche WebLink
everett <br />City of Everett <br />Engineering & Community Services <br />Sewer Application and Permit <br />N0. L l la J DATE �%/l" eK <br />CHART NO._ <br />U <br />2_.; S <br />Service Addresses Utility Account No <br />Billing Address <br />City, State, Zip <br />Owner (Mortgagor) — <br />Billing Name <br />:r <br />Connection By <br />Address — <br />Phone <br />DESCRIPTION: <br />Lot Block—_ <br />t <br />Plat — <br />Unplatted Descriptinn <br />Tcne Permit: -. - <br />SEE SKETCH ATTACHED <br />1 <br />Permit <br />Connection Charge(s) <br />Total Fee (.-, <br />Signed <br />Customer <br />Sewer District <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 />City Engineer <br />Issued By - <br />Inspection By <br />Date Inspected % <br />NO. <br />