Laserfiche WebLink
tl <br />everrtt <br />e <br />City of Everett <br />Engineering & Communiiy Services <br />Sewer Appl�cation and Permit <br />�� o. ; ` � � -: � <br />_ : :):; � DATE ��! :� i <br />Service Address_ ' - <br />Billing Address � <br />>. "' , - , /� ?s. <br />City, State, Zip --' _ . +,: ; , , <br />Owner (Mortgagor) <br />Billing Na <br />Connection <br />CHART NO�y� <br />� � � �� <br />; �-� . , . <br />Utility Account No._ <br />Permit Fee <br />Connection Charge�sl_ <br />Total Fee <br />,�' ,: <br />�,-.Z d ��� <br />� �1 <br />, <br />.�t - <br />� r �/ , <br />Address 1' � � .. - <br />•,.. . ,�Signed (.' %: � `�J__ r ;,;,c�, <br />PhOfIB . Customer' <br />DESCRIPTION: <br />Lot Block � <br />Plat <br />Unplatted Description�__ <br />Type Permit: <br />SEESKETCH ATTACHED <br />� I�!i�yi'! f'llOi' <br />Sewer District ' ` <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Trurn <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />APProved By_ ,!(,�� . <br />� Ciry Engineer ' � � <br />r <br />. <br />Issued By �. ,f� . � <br />nspectian By_ /` �h-zy 7 � <br />/ � / <br />)a[e Inspected_ P � ( o_��� , <br />, 5: �a .i:!. <br />— :;� <br />