Laserfiche WebLink
, <br /> � <br /> a <br /> eWere�t �� <br /> CHART N0. � <br /> � -�o pasE.;ny _ <br /> �.� <br /> :� 4-ZCa- 91 <br /> � <br /> s�2 <br /> City of Everett � � � <br /> Ud <br /> � r, :: <br /> n, ,�. .r. . <br /> Sewer Applicatioq.,�r�d Permit <br /> �� � � � <br /> r, � _ � ; <br /> NO. Z S Z Z Z DA'1� � � ,� <br /> � <br /> aril ^7, iQul <br /> Service Address . Utility Account No. <br /> Billing Address y, , 1 <br /> + City. State.Zfp Y+=kl and, vn gan34 Permit Fee $ _�A,8� <br /> Owner , Connection Charge I <br /> � <br /> ' Connection by Trunk $ <br /> ..,. , <br /> Address _— <� � Lateral $ <br /> ,. , Total Cor.nection Charge $ <br /> Phone ��_ Utiliry Development Fee <br /> ` Legal Description: Water $ <br /> Lot —r�� �tb ��e. Sewer $ <br /> Block Total Deveiopment Fee $ <br /> Plat ____ <br />� Unplatted Description: Sewer Bond District <br /> Abutting Lot Line <br /> — N, S, E, W h. <br /> Tyre of Permit ����Se�er Approved By <br /> Remarks Issued By r- uN+„ _ <br /> Customer Signature <br /> IMPORTANT! <br /> C�hLL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING � <br /> CALL 259-8810 FOR INSPECTION Inspection By����� � /.� <br /> Date Inspected �?�_��� <br /> � <br /> SEE SKETCH ATTACHED N0. �BZ�L <br /> '� INSPECTION � <br /> i <br /> I <br /> � <br />