Laserfiche WebLink
�.� <br /> everett CHART N0. <br /> \ x <br /> \ � <br /> 11 � � <br /> \ City of Everett � � � $ � <br /> � y <br /> \\ � M N � � <br /> �', Sewer Application and Perrr�it t � I <br /> � <br /> , ��. � <br /> � � <br /> ' 26064 , � � � � � � <br /> \ N0. DATE <br /> Service Address�Te�� ��I1 � /;� f/- <br /> '! � �Utility Account Nu. <br /> BillingAddress /7d�7 !.�'}//I � '-��=— <br /> Permit Fee— /( ) <br /> City,State, Zip_ G�C.R�_,� �� � Connection Charge�s) <br /> Ownar (Mort a or) —�:�-=�.'�"'.•_- �j � �� � �-'� <br /> 9 g ��� � Total Fee / <br /> Billing Name Fpi.I Ni.JQ.S����`�_ <br /> Connection By_ / <br /> Addres� Signed ' 7�� <br /> , <br /> Phone c��w�„�� <br /> DESCRIPTIpAI: Sewer District ' i � I// <br /> . Lct�_ Olock I <br /> Plat ��S Monthly Sewer Service <br /> Unplatted Description Monthly Sewer Constr. <br />� Typa Permit: ,e � Trunk <br /> rY�jr , . �r� �l L. <br />� Lateral <br /> I Remarks: ( ,� , / � � % / <br /> � '—� Abutting Lot Line <br /> N, S, E, W ft. <br />, Approved By_ %�1 l .:i � r) �� i� f-=f�[_ <br /> QIy Enpineer <br /> I�IPORTANTI /I , <br /> CALL 1?OOd24-665548-HOURS Issued By �/A h ' 1 �L � �� �./ ��� <br /> PRIOR TO DIGGING � <br /> CALL 269A811 FOR INSPECTION <br /> Inspr.ction By <br /> Datelnspected <br /> SEE SKETCH ATTACHED Np, Z6OG4 <br /> , INSPGCTIOiJ <br />