Laserfiche WebLink
everett <br />� <br />� <br />Cit�� of Everett <br />Sew�r Appli��tior� and Persnit <br />CHART <br />�.��f �a C%1u�t�-�� / -J,4 -39 <br />No. 26 �'43 DATE �une 27. 19E�6 � <br />Service Address _ Utility Account No. <br />f3illing Address <br />�City, State, Zip_g � <br />Owner (Mortgagor�� <br />Billing Name_—� <br />Connection By <br />Address �— <br />Phone <br />DESCRIPTION: <br />Lot •+ Block <br />Plat <br />Unplatted Description <br />Permit: <br />Remarks: <br />IMPORTANT! <br />CALL 1-500-02A-5555 48-HOUHS <br />PR�OR TO DIGGING <br />CALL 259-8817 FOR INSPECTION <br />SEESKE7CH ATTACHED <br />Permit Fee <br />Connection Chargels) , <br />Total F <br />Siwcial Utility Fee ORci. 1171-85 <br />vaLer 224.00 <br />sewor 589.00 <br />Y'&�YOS , <br />Signed $13.00 � � — <br />Customer <br />Sewer District �n� I <br />MonthlySewerSer�i'6e`F&� `;�:��Fti �NJiN+S;1:'4'i �"1�t� <br />Nlonthly Sewer Con's�V:'�a''''' <br />IuaTI:R xE�l.i!i) <br />Trunk �;j)LJI::Q�i� <br />t:.:L .N <br />Lateral F'�� �f.(i.C�CI <br />�— <br />PiJI 1;51 43i3.Ui. <br />' Abutting Lot LineC ��{ Y.>,.°A <br />N, S, E, W r ft. <br />. �N•. J• <br />fi��](J2'oltiJ <br />:k IdER i �O.Qi] <br />B}IG T .32C QU <br />is;i-.; 7t;is.�ro <br />Approved By ^ <br />' rty 'ngineer - <br />Issued By Susv Aat;gen <br />, � <br />Inspection By ` <br />Date Inspected ��� ��� <br />, <br />INSPGCTION <br />No. 26743 <br />