Laserfiche WebLink
City of Everett <br />Engineering Department <br />Sewer Application and Permit <br />N0. 1, 1 DATE <br />Service Address________ _ _ S� Utility Account No. <br />Billing Address _ _ Connection Permit Fee — <br />City, State, Zip_ ___ Connection Fee <br />Owner (Mortgagor)___ Total Fee <br />Billing Name <br />Connection By_. ­ <br />_-__ <br />Signed <br />Address Signed ' <br />Customer <br />Phone <br />DESCRIPTION <br />Lot <br />Block___ <br />Division or Addition.--�+� <br />Sewer District <br />Remarks: <br />SEE SKETCH ATTACHED <br />Monthly Sewer ServicE <br />Monthly Sewer Constr <br />Approved By ­ <br />City Engmenr <br />Issued By <br />Connection By <br />Inspection By ��•�' <br />)ate l nspected <br />