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!Y!Ilfl <br />e <br />City of Ewrett <br />$ewer Application and Permit <br />CHART NO. <br />s�,r ra ci/a�r.��� /2�/96 <br />No. 25449 DATE ���' �� 1986 � <br />Service Addreu_ �2� Dow� its�t Utility Account No. <br />Billing Address e_e_ � 1�� <br />City, State, Zip �^!�r �• m� <br />Owner (Morigagor) �t��O �� �� <br />Billing <br />Connection <br />678-�106 <br />DESCRIPTION: <br />Lot � Block <br />Plat ii���s �1�:a <br />Unplatted Description <br />Type Permit: <br />Remarks: <br />IMPORTANT! <br />CALL 1�800�24F555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259�8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Permit Fee 30•0� <br />Connection Chargels) <br />Total Fee 30.00 <br />OrEla�eo� 1171-oS <br />11aC�s 23�.00 <br />i <br />� <br />Signed <br />cu:romer <br />7 <br />Sewer District Bmd =i <br />Monthly Sewer Service 6_So <br />Monthly Sewer Constr. <br />Trunk <br />Abutting Lot Line <br />N, S, E, W <br />P.pproved By 1►. R. 'lh�al <br />City En9ineer <br />Issued By t. �ad <br />Inspection By �� � <br />Date Inspected � % �6 <br />No. 25d49 <br />INSPEC�iION <br />