Laserfiche WebLink
� <br /> � <br /> CHART N0. <br /> everett <br /> -�� �o,i;,-.� <br /> 5- ��r -� i <br /> A <br /> City of Everett ;� � .� <br /> Sewer �pQlication ar�d Perrnit <br /> NO. Z� 2�.� ,'� DATE �.F-��� ��, �rS� ' <br /> Service Address , � Utility Account No. — <br /> Billing Address - <br /> City, State,Zip �� � � Permit Fee � <br /> Owner �_��;�� Connection Charge <br /> Connection by y�r Trunk $ <br /> Address _ Lateral $ <br /> _ Total Connection Charge $ <br /> Phone Utility Development Fee <br /> , Legal Description: Water $ <br /> Lot �,�,�: $ � Sewer $ <br /> Block Total Development Fee $ <br /> Piat <br /> o , .; . � <br /> �nplatted Description: Sewer Bond District <br /> Abuttiny Lot I_ine <br /> N, S, E,'JJ _ ft. <br /> Type ot r ermit ::1.r: ca:+ ,' r�rr •: Approved B}� <br /> Remarks _�;��3f,�� Issued By_�� we <br /> Customer Signature <br /> I IMPORT,ANT! <br /> � <br /> CALL 1-8D0-424-5°i55 48-HOURS <br /> PRIt7R TO DIGGING ;%'�' j ;,� .. ' ' <br /> � <br /> Inspection By��' �' ��� <br /> I CALL 259-8810 FOR INSP�CTION � � <br /> Date �nspected _ , <br /> � <br /> � <br /> SEESKETCHATTACHED No. Z$Z��3 <br /> INSPECTIOi: <br />