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everelt <br />e- <br />City of Everett <br />Sewer Application and Permit <br />NJ. %3673 DATE �' �-�- � <br />Service Address ��� �� l� � Utility Account <br />CHART NO..�: .--�%�T' � <br />�G <br />� <br />o� <br />Billing Address�%d�� r'� � Permit Fee �� <br />Cit <br />Ow <br />Bil <br />Co <br />;onnection <br />0 <br />O' � <br />Total Fee � — <br />Signed <br />cu:mmer <br />DESCRIPTION: Sewer District <br />Lot _ Block Monthly Sewer Service_ <br />Plat <br />Unplatted Description �>' ' �' � ' - 'i'� Monthly Sewer Co+�str. <br />T...�u Dcrn.ir• . '�~ . <br />SEE SKETCH ATTACHED <br />INSPECTION <br />Abutting Lot Line <br />N, S, E, W. <br />Approved By_„X° ' fa'i'c-h'..-',,..cJ <br />city oyioeer <br />ISSUCd By' ��� <br />Inspection By , <br />Datelnspected <br />No. 23673 <br />