Laserfiche WebLink
i <br /> CHART N0. <br /> everett <br /> _�v �o5�:n� I <br /> � - 2 �- 9l I <br /> QG <br /> City ot Everett � - <br /> Sewer Application and P�rmit <br /> i N0. L$�1�� DATE -- <br /> Servlce Address �_-_1QIlt]L1'1�E------- Utiifty Account No. — <br /> BIIIing Address ��—�9(�!# "�—B$ - <br /> City, S�ate, Zip � Permit Fee $ �g,.+w— -- <br /> Owner a M�icm ra��r+r� ConnectionCharge <br /> Connection by �,,..� Trunk S — <br /> Address Latoral E — <br /> r��� .._..___ ..��y ��__. Totat Connoction Cherge S <br /> Phone yy� ++. Utiliiy Dovelopment Fee <br /> Legal Descriptlon: Water S <br /> Lot Sawer $ <br /> Plock Total Development Fee $ — <br /> Plat ---- <br /> Unpletted Descriptlon: Sewer Bond District <br /> Abutting Lot Llne <br /> N,S, E, W -- h. <br /> Type of Permlt +�.. ..�.�wrn,. Approved By <br /> Remarks _(ISIIZ]0) Issued By _���---•�— <br /> / i <br /> _ _ Customer Signeture — <br /> IMPORTANT! <br /> CALL 1-800-424-5555 48-HOURS <br /> PRlOR TO DIGGING �` � /� �' <br /> fnspection By <br /> CALL 259-8810 FOR INSPECTION � <br /> Date Inepected -- <br /> SEE SKETCH ATTACHED No. Z8Z16 <br /> � ���� r�r ��r; ior� <br /> �I /;, , <br />