Laserfiche WebLink
everett <br />� <br />City of Everett <br />CHART N0. <br />- ;'' ' � ��i� ' / <br />�. ,, <br />Sewer Ap�licatiom c�nd Permit <br />NO. L�`��� DATE ' <br />Service Address � Utiiity Account No. <br />Billing Address g„{3i �e* ygi Permit Fee �0. 00 <br />City, State, Zip ♦ L��T1r4..»... � gg� s�g <br />Owner (Mortgagor) ����m}pp, <br />Billing Name � <br />Connection By Same <br />Address Smaa _ <br />653-2025 <br />Connection Charge(s) 330.00 <br />Total Fee 30.00 <br />Specinl Qtility Fee Or3. 2171-85 <br />vatc�r 179.�0 <br />eeWer 471.U0 <br />650.00 <br />Signed <br />Cystomer .. <br />u.�..., � ...i'.ii�li Ia�I�;Lill';I.`� . _. - <br />i. ,ri::,::, <br />DESCRIPTION: Sewer District �dtE4i Bond.,2il <br />Lot �= Block i'I.iti; ;��`,�,.i��a: <br />Plat Laraon Placo MonthlySewerSerqic� — <br />E: ".f'r;i _';i <br />Unplatted Description Monthly Sewer Constr: i i� , i-, ;„; <br />i,;;��a� � i•,, <br />T e Permit: Trunk �., ,� 330. o�c� <br />1'P ttew Connection , ,,;;. � , <br />� Lateral�T <br />Remarks: , : ;1 '. •:�:'.;u, . <br />Abutting Lot Line,,,ah;::_';,Yr <br />N, S, E, Wi� ��:� ft. <br />�'ii.ii, :�: <br />IMPORTANT! <br />CALL 1-800�424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8811 FOR INSPECTION <br />SEESKETCH ATTACHED <br />Approved By r.LFR�n �e. 2t3snr. <br />City Engineer <br />Issued By suay ttaffg{�at t�aug�n <br />Inspection By--�`- <br />Date I <br />I f�d'�i' GC'Ti Oi'J <br />No. 26469 <br />