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, <br /> ,, y3� -z5 s <br /> i_�-�'- � � � � ' CHART NO. <br /> l <br /> ever:�tt <br /> � f�T�� � '" �`sr� <br /> City of Everett � <br /> r A lication and Permit � <br /> Sewe pp � <br /> No. �3509 DATE 2/ZZ/60 <br /> Service Address 4�10 Cblby Utility Account No. <br /> 1002 lOth 30.00 <br /> Billing Address Permit Fee <br /> 8aohc�ish. Ma. 96290 Connection Chargels) <br /> City,State, Zip 30.00 <br /> Owner (Mortgagor) ��1���D� Total Fee <br /> Billing Name �tle�/Ool� <br /> i <br /> SaM f � ,�'� + <br /> Connection By i/� �, i/ f <br /> � ✓ � I <br /> Siyned ` � <br /> Address j Cu:tomer <br /> 568-4011 <br /> Phone <br /> i <br /> DESCRfPTION: Sewer District i <br /> Lot � Block �6 Monthly Sewer Service Metered � <br /> Plat �� P� � � <br /> U�platted Description Monthly Sewer Constr. � <br /> Trunk _� <br /> Type Permit: !tw Oomwclim <br /> Lateral <br /> Remarks: Abutting Lot Line � <br /> N, S, E, W �ozlha°d it. <br /> � j !/� APProved 6y N. Bassyn <br /> . CitV Engineer <br /> Issued By E• 8°aa <br /> -.i <br /> i ' <br /> —'— Inspection By � <br /> Date I nspected�Z ' Z z — b' O <br /> SEE SKETCH ATTACHED ND• Z3509 <br /> � <br /> INSPECTION � <br /> I <br /> r . <br />