Laserfiche WebLink
everetl <br />City of Everett <br />Engineering [Department <br />Sewer Application and Permit <br />NO.'L16461 <br />DATE c„ i <br />Service Address L Utility Account No. <br />Billing Address ? ' i Connection Permit Fee_ <br />City, State, Lip ) i_ k 1- TT Connection Fee — <br />Owner (Mortgagor) /�•` J< Total Fee_ <br />Billing Name k' i _> I„ ^.l E a <br />Connection By % J'= ut r' W _ /l iC t✓ <br />t; r <br />Address % 11.7 � � !'� L'A - k'E;TTSigned <br />Customer <br />Phoneme � <br />DESCRIPTION: <br />Lot <br />Block <br />Division or Addition <br />Sewer District <br />Monthly Sewer Service <br />Remarks: I Ir'L f.7 ( x <br />Mo <br />ISsi <br />Co <br />Ins <br />Dal <br />z <br />SEE SKETCH ATTACHED <br />INSPECTION <br />nthly Sewer Constr <br />arwed By Nisi% <br />City Engineer <br />led By ' <br />inection B <br />pection By_,�� ,J =' <br />e Inspected 11-- 7 <br />