Laserfiche WebLink
ev�rett <br />� <br />City of Everett <br />Engineering & Community Services <br />Se�ver Application and Permit <br />CHART N.C�y��' �' 6`� b� t <br />� <br />f�� � �� G �%J ; <br />� <br />�- 2-�5- �� � i <br />� ..; � <br />N0. r'. ,7 U l_ DATE � ��-7,' <br />Service Address � � � � '�' � <br />Utility Account No. <br />Hiiling Address �'� 3.�/�- Permit Fee <br />City,State, Zip '� v.:ilr" '- 1i.i,�S�� 'l� •%"% Connection Charge( <br />Owner (Mortgagor)_ i�l 7)-!� �.: �: a i;./ Total Fee <br />BillingName_ S�i::J�= <br />Connection By � � i __ '.� <br />Add�ess `. � � „ ..' tY �.Z f:,i,�:<:r.: � Signed_ <br />Phone_s� � ' �- i ,a <br />0�.� c'��� �C.. , <br />Y <br />:; <br />�' .. <br />DESCR�PTION: Sewer Disirict <br />Lot Block ' ' '�'_ <br />Plat ' �' ' / � Monthly Sewer Service <br />Unplatted Description Monthly Sewer Constr. <br />Type Permit: Trunk <br />I. .;J:.< j,Lt :v�i ;��t'lv:�7L /�i�0��'K; y Lateial_ <br />Remarks: �� <br />SEE SKETCH ATTACHED <br />' �`g� � .p�iL r„�,,i'i-.t,lli'`� <br />e"'9t±+'� Y .4f.'1' ��.� F� <br />,- ��.` n <br />��,Rb. . . _ . , i _ <br />Abuttii�g Lot Line <br />N, S, E, W <br />-%� , i. <br />APProved By '' F-.• ..�,,_. <br />Ciry Engineer <br />�• �� <br />Issued l3y , ,��.' �,;;.!c<,- <br />Inspection By_ � / C / � c� � <br />Date Inspected Ci - �'� — 7% <br />NO. � , _t <br />t c'a �� sn'�s q.r eu�+r+w�us,c�n .. ry�g �r'. a ... <br />