Laserfiche WebLink
everett <br />� <br />City of Everett <br />Engineering Department <br />_i� . !. -.... .rr_ <br />}; � �! �,�� , � <br />�._ Q- %, ; <br />r�"�: � �^�,,.. <br />Sewer Application and Permit <br />N0. _.:_JUU DATE <br />Service Address <br />Billing Address <br />City, State, Zip <br />Owner (Mortgagor) <br />Billing Name <br />Conne�tion By <br />Phone <br />DESCRIP'ION: <br />Lat <br />Block_ <br />Division or Addition <br />t_.__ �_....:.. <br />Utility Account No. <br />Connection Permit I <br />Connection Fee_ <br />Totaf Fee <br />Signed — c�:iome� <br />Sewer Distnct <br />Monthly Sewer Service. <br />Monthly Sewer Constr. <br />SEESKETCH ATTACHED <br />� <br />u <br />Lateral <br />Abutting Lot Line <br />N,S,E,W <br />Approved By <br />Ciry Engineer <br />Issued <br />Inspectian By <br />Date I nspected � �6 � <br />• i n - <br />NO. _ I.._; ii t- <br />