Laserfiche WebLink
everett <br />e � <br />City of Everett ' <br />Engineering Department <br />Sewer Application and Permit <br />, -- <br />rvo. �i.'� 3 �; , <br />Service Address_ <br />Billing Address_. <br />City, State, Zip_ <br />Owner (Mortyagorl <br />Billing Name_ <br />C�nnection By_ <br />Phone <br />DESCRIPTION: <br />Lot <br />Block_— <br />Division or Add <br />DATE <br />_ 3-z6-3�7-Oo <br />_ Utility Account fJo. <br />Connection Permit Fee — <br />Connection Fee <br />r Total Fee_ - ` <br />�Y <br />� ___.-- .. .__ . <br />SEE SKETCH ATTACHED <br />_/ <br />y <br />Se�Ner Dis[rict <br />Monthly Sewer Service ' <br />Monthly Sewer Constr.__�__ <br />approved av — <br />City Eng�nccr <br />Issued By -- <br />Connection By �.U_���— <br />I�ispr.ction By�/�����-.u//— <br />Date Inspected_ C�- 1 � <br />