Laserfiche WebLink
everett <br />e <br />City of Everett <br />Engineering & Community Services <br />Sewer Application and Permit <br />NO. ;� ,� i �S ,`] DATE 5 /��/�+� <br />ServiceAddress'`���s �%r%/l'�'�'° ��_ <br />r <br />Billing Address �'`� 3�� - '�''"L`� ��"�'�'�" � <br />CitY, State, ZipGfr !�-��' :'i%L. '`�� =�U ! <br />.i , ; i <br />Owner (Mortgagorj �l�"`-� v (_��'�% —�' <br />� <br />Billing Name —%=%�' ' �' <br />i <br />Connection By --��--��-- :- _ <br />Phone �'` S'� — ��� �6 <br />CHART N0. � �� <br />� . <br />� <br />��� ��. � <br />T/�yT� � <br />.��w �.. <br />. <br />Utility Account No.. <br />� � ��� <br />Permit Fee <br />Connection Charge(sl �`�� " <br />� �i <br />Total Fee 3 <br />'��� ��� <br />�' l/ . <br />Sign�d �:'-�� ;��I"��/+'+,e <br />Customer <br />DESCRIPTION: Sewer Dis[rict _ <br />Lot Block '—'—� <br />Plat <br />Monthly Sewer Service �% ••' ' f �; �. <br />Unplatted Description�-� •�='U ��% -' +%�/ Monthly Sewer Constr. <br />SEE SKETCH ATTACHED <br />Trunk <br />Lateral <br />Abutting Lot Line ��� ' <br />N, S, E, W �/r-:r'r�� .J tt. <br />r__... _�/ • • <br />Approved-$Y . �'" . . . , <br />4' � Ciry Engineer <br />�. _ !. <br />IssuedBy '� ' �JJ=-""'=..� <br />Inspection By ,'��� <br />Date I nspected � � �LD� <br />NO. <br />