Laserfiche WebLink
CHART NO.—� �i8 z8 s <br />ieeveretl <br />City of Everett <br />Engineering & Community Services <br />A <br />Sewer Application and Permit <br />/" , / _ I <br />N0. %L(�;%�; DATE <br />Service Address /�--- --_ <br />Billing Address <br />City, State, Zip <br />t <br />Owner (Mortgagor)_ <br />Billing Name <br />Connection By_ <br />Address -- <br />Phone _- <br />3s ;_77a0 <br />DESCRIPTION: <br />Lot Block <br />Plat / �= <br />Unplatted Description <br />Type Permit: /. <br />Remarks: <br />SEE SKETCH ATTACHED <br />Utility Account No. <br />Permit Fee a <br />Connection Charge(s) <br />Total Fee <br />Signed / <br />C.10m r <br />Sewer District f- <br />Monthly Sewer Service— G <br />Monthly Sewer Constr. <br />Trunk "y <br />Abutting Lot Line <br />N, S, E, W <br />Approved By <br />Cny Engineer <br />Issued By <br />Inspection QB�� <br />Date Inspected <br />NO. '1 <br />