Laserfiche WebLink
evePett � <br /> .e � � ��' �`� � � � ���� <br /> City of Everett <br /> Engineering Department <br /> Sewer Application and Permit <br /> J l) i i. 4 .. <br /> N0.-�- � J �u DATE � � <br /> Service Address Utility Account Na. <br /> Billing Address Connection Permit Fee <br /> City, State, Zip ' � Connection Fee <br /> Owner (Mortgagor) � Total Fee <br /> Billi �g Name <br /> Connection By - <br /> Address_ Signed <br /> c��s�o�„�, <br /> Phone - � <br /> DESCRIPTION: <br /> Lot <br /> Block <br /> Division or Addition <br /> Sewer District <br /> Monthly Sewer Service_ <br /> Remarks: , <br /> _ , ._ Monthly Sewer Constr. _ <br /> r. ' 7 <br /> � �c� r � ���`�,d� aT �� ��x /? �¢�.0 APProved By <br /> Cily Enginerr <br /> ��y lk��� 5 �� /�—� �fl+--it �-Lr. . �. <br /> Issued By <br /> Connection By <br /> � ---- <br /> Inspection By �-� v' �-�C.,-,rc� <br /> Date Inspected ���/°�7 3 <br /> � — — <br /> SEESKETCH ATTACHED j <br /> \ <br /> 1 <br /> \ <br />