Laserfiche WebLink
everetl <br />� <br />City of Everett <br />Engineering Department <br />.� <br />�_ <br />, . <br />� <br />� <br />I <br />Sewer Application and P�ermit <br />NO. �,.�. <br />-`-� J J c. <br />Service Address_ <br />Billing Address <br />City, State, 2ip �� ' •� - <br />Owner (Mortgagorl ` <br />Billing Name <br />Connection By —�-- <br />Add ress _—_ --- <br />Phonc--- - <br />DESCRIPTION: <br />I_ot --- <br />Block _. _../ . - <br />Division or Addition <br />Rem. rks: • <br />� <br />� <br />,�G_ <br />Utility Account No. <br />Connection Permit Fee --- <br />' ( , <br />� Connection Fee_ -- <br />Total Fcc_.___ -- - - <br />;in:�ed-- ---- --- - - <br />- - r ���,.�. <br />Sewer Uistrict_ <br />MonthP/ Sewer Service__ <br />MunthlySc.�crC�u�s�r.--- ----._..------ <br />� <br />/� - y <br />��.�C�ti�L �� 1• f- a.� SU �t , —_. . - llppruvcil fiY--�--------�-- '� - - �- --- <br />�"'- r,�is [��y����.." <br />— — <br />_�'"�� P � �� � �i.�u-a-�. c�¢-c.�... ' Issued BY --- . _ _ __ — <br />Conneclion By <br />_ InspectionBy �• ���',�'L •�s�� -- <br />- Date � nspa.trd i <��r z. / 7 '� . _ <br />li <br />�;ri: �;i<rrci� nTr,�crii_i� <br />