Laserfiche WebLink
everett <br />� <br />City of Everett <br />Engineering Department <br />Sewer Application and Permit <br />NO. ' -L _� _L .�' DATE <br />5ervice Address � �� �"�'� 1� c i-tL <br />�—r.�—�—� <br />Billing Address ��-,OaR' - <br />City, State, Zip� VE i.° c r¢ ��� 7� 3 <br />� <br />Owner (Mortgagor) _ <br />Billing Name <br />Connection By .� + � ���• <br />DESCRIPTION: <br />Lot _.— <br />Block <br />Division or Addition <br />Type Permit: <br />Utility Aicount fJo.. <br />Connect�on Permit F <br />Connection Fee_ <br />Total Fee <br />Signed <br />Customer <br />SEE SKETCH ATTACHED <br />I�I�:,��i <br />Sewer District <br />Month�y Sewe� 5ervice <br />Monthly Sewer Constr. <br />Abutting Lot Line <br />N, S, E, W ft. <br />Approved By <br />Ciry Engineer <br />I ssu ed <br />Inspectian By � <br />Date I nspected . <br />No. 21?1� <br />