Laserfiche WebLink
everett <br />City of Everett <br />Engineering Oepartment <br />�e�rer j4�plication and Payrmit ' <br />N0. <br />DATE <br />Service Address_ �� :Z r% ��y �lf I.(J <br />Billirn� Address <br />City, State, Zip <br />Owner IMortgagor) <br />Billing Name <br />�–, , <br />� • - :7 �' <br />.� – �7� — 70 7 – c7C -- <br />Utility Account No. `�_.-, <- ' i'/ e.•• �,i �• � <br />.�–�- � — – <br />Connection Permit Fee <br />Connection <br />Total <br />Connection By ___ PC;�� <br />l+ddress ��7i'G?4 t'/�ln/i �/k LOJ(/�i'S� Signed <br />�� Customer <br />Phone � �S –' �� Z-7� <br />DESCRIPTION: <br />Lot � <br />Block <br />Division or Addition <br />Type Permit: <br />SEE SI<ETCH ATTACHED <br />Sewer <br />A�onthly Sewer Servi <br />Monthly Sewer Constr. <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved By <br />Ciry Engineer <br />Issued <br />� ` <br />Inspection By '� <':.,.J <br />Date Inspected �J�/ 7/% % <br />I NO. , , .. <br />