Laserfiche WebLink
everett <br />. <br />� <br />iCity of Everett <br />� Engineering & Community Services <br />, '�� .� �J ,c (' , - / � - . , <br />.. <br />. ,:� <br />� �,, <br />.�'�-�ri <br />Sev�er �pp{ication and Per�it <br />CHART NO�._LG�`_�•��� <br />7` <br />; G,: <br />NO. DATE ' " I <br />Service Address_ ���� > / %'� -' -- %- Utility Account No. %' -� '' __ _ <br />, � <br />Billing Address -' G• -= � ` 7� 7 Permit Fee '' <br />City, State, Zip � ' 'G � • '�" �"v -' Connection Charge�s) <br />- �• <br />Owner (Mortgagor� - ✓ !f -_ Total Fee_ _ _ <br />Billing Name_ �-�" <br />Connection By ' ' '� _ <br />Address __ Signed . %'�`. <'�''!� /•'�� ' �-.-___ <br />� � ( <br />. � usiomer — --- <br />Phone • �" �- � � <br />DESCRIPTION: <br />�ot � � Block <br />Plat --- � - - �� <br />Unplatted Description <br />��. , � <br />Tvne Permit ,. _ � . • <br />SEE S:<ETCH ATTACHED <br />_; �� <br />:�.` <br />� <br />Sewer District J /_ <br />_ .� <br />Manthly Sewer Service _ .--'_-:_: <br />Monthly Sewer Constr. <br />Tru n i: <br />Lateral__ ___ ____ _ <br />Abutting I_ot Line <br />N, S, E, W <br />Approved By_ <br />City Enpinecr <br />�55LICC� �)i __—_—' —'_ ___ _._ <br />t. <br />I nspectio�i 3y � e--c_[_C_'�2_��_`--"__— <br />Date ! nspected��? �� _ <br />NO. <br />