Laserfiche WebLink
cverett <br />I � <br />I City of Everett <br />i <br />i Sewer Application and Permit <br />� <br />CHART NO.___'K. � <br />, ,, __.. _ <br />� C'�:> / �J I <br />-� /�• �� <br />9� � <br />i N0. ZZ9OO DATE _ _ I <br />� <br />iSr.rviceAddress ___ ' Utility Account No. !' -- %" ! �i <br />� Billing Address '` ' i. � T _ Permit Fee �� � <br />City, Siate, �ip! , i i f �'� . � __� v� � <br />, ' i Connection Charge�s) - - � ' � �� : �i f � <br />-r— <br />Owner (Mortgagor�_ �- � r c • <br />Total Fee _ <br />Rilling Namc <br />Connection By__ • 1 =- <br />Adc�ess � �' � Signed_ � �----. <br />. customr� — <br />Phone " I <br />DESCRIPTION: Sewer District_� ____ � <br />Lot_) Block_______ <br />Plat ___ Monthly Sewer Service______ �� <br />------- � <br />Unplatted Description _________ Monthly Sewer Constr. <br />s <br />Type Permit ',. �C_i t% _ Trunk_ i� <br />� C � , i ia <br />Latcral ��:.' <br />Remarks: <br />Abutliny Lot Line <br />---- N, S, E, W f. <br />SEE SKE7CH ATTACHED <br />` � �.: <br />Approvr.d8y/. ��_._;.;�.�i;.'� <br />C�Iv Enginner <br />�SSUCCI By / `�..� � . �.�_� : � <br />i,' <br />Inspection 8�� �l � r -C <br />Y'�-�` — -- _ — <br />��`��__ <br />Date Inspected e�= ��� _ <br />NO. ZG9OO <br />