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CHART NO.— <br /> everetl <br /> e ��N-� � ra F�����-��.�b <br /> � /l� � �� <br /> City of Ewrett <br /> Sewer Application cnd Permit <br /> No. 26936 DATE � g• 1�8 <br /> Service Addr�ss ��� �Qk �t � Utility Account No. <br /> BillingAddress 19125 �i. �Mk Plnrt �111 Permit Fee_ 30.n0 <br /> City,State, Zip �11, IG 98011 Ccnnectior Charge(s) 110_00 <br /> Owner (Mortgagor) �k Gzatt Total Fee 30•00 <br /> Otilitp Dsvelopmmt �ae Ord. 1171-85 <br /> Billing Name � �tas i21.Op <br /> Connection B �lwtb�s IW��s saror 589.00 <br /> Y �-a13,00 <br /> Address i�a� Signed ` � r1`,,,� � i <br /> Customer <br /> Tone �83-0lOf <br /> DESCRIPTtON: Sewer Distri�t �d I <br /> r 4� <br /> Lot � Block <br /> �k �� �M Monthly Sewer Serv' <br /> Plat <br /> Unplatted Description Monthly Sewer Con� �'�7°� <br /> #bO.C� <br /> Trunk ��10.0O.s7.50 <br /> Type Permit: •` <br /> Lateral � `�'� '�3'� <br /> Remarks: �` a�•� <br /> Abutting Lot Liney��I.r3 <br /> N, S, E, y� � ft. <br /> EkiO(k^bR3b <br /> S`E1�k �130.W <br /> � I S11U.f10 <br /> C <br /> Approved By ��n9,�; e <br /> IMPORTANT! gry � <br /> Issued By <br /> CALL 1�00-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> CALL 259-8811 FOR INSPECTION <br /> Inspection By �"'� �— <br /> Datelnspected j1 -�' 'g3 <br /> SEE SKETCH ATTACHED No. 26936 <br /> I f:;:PEC I i Oiv <br />