Laserfiche WebLink
CHART NO. <br /> everett <br /> T� t�csk�r� <br /> 4-zs-yi <br /> I <br /> City oi E:verritt I <br /> Sewer Applec�tio�r and Perr�it � <br /> � <br /> � <br /> NO. 2 H 2� 3 DATE __�_.y .�—_—_ _ <br /> Service Address ���n_�- - -- Utility Account No. --- <br /> Billing Address � A o�e <br /> City, State, Zlp Permit Fee $ <br /> Lverett, WA 90208 • <br /> Owner _�_��pa}}K— Connecllon Charge i�, ,,-;•y� 10�OiW1 IIflOAN�.uli4 CI � <br /> Connection by _��— Trunk .���x � <br /> � . <br /> Address Lateral ''�� �''�'W <br /> arc ay d 'A'�11 i"��l.flfl I <br /> � Total Connection Cherge E � <br /> Phone , Utility Development Fee I <br /> ILegalOescriptlon: J Water $ li <br /> Lot Sewer S — I <br /> Block _ Tolal Development Fee S � <br /> Plat _ I <br /> Unplatted Descriptlon: Sewer Bond Dlsirict I <br /> Abutting Lot Llne � <br /> N, S, E,W — — n• I <br /> Type of Permit �4i� 6erer Approved By ! <br /> � Remarks Issued By <br /> i __ ___ __. Customer Slgnature--_ ' - — ' <br /> I IMPORTANTI <br /> I CALL 1-800-424-5555 46-HOURS � <br /> I PRIOR TO DIGGING � � - � <br /> � Inspection B — <br /> I CALL 259-A810 FOR INSPECTION <br /> Date Inspected �S s <br /> I SEE SKETCH ATTACHED No. 28223 <br /> � �, �� ; <br /> � , . <br /> ! <br />