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� y <br /> Q� H . <br /> �H � <br /> ��� <br /> � �� <br /> H <br /> y y . CHART N0. <br /> x everett <br /> o� d <br /> � e : <br /> ��g � <br /> �y� City of Everett � � 'T ' " � <br /> HH �:, -, ,, •� <br /> g y ; ,: .. . _ <br /> , � <br /> H �y <br /> ��� Sewer Applicatio� _.�n� Rei�mit <br /> rc - r.• 4 � �` <br /> ►�w �: = 3 � � � � _ <br /> ,S' <br /> y ^ _ w _ �} 8 �. <br /> ^i _,= � _c o, - � - ::_ .J <br /> No. 2$ 53 3 na� �2-3-0� <br /> Service Address ��l3 6AttES AYE Utility Account No. <br /> Billing Address <br /> City,State,Zip Permit Fee $ _ 2.�0 <br /> Owner NAROLD CALLAt1AH Connection Charge <br /> Connection by Trunk $ <br /> Address �2Z6 BIC� AYR Lateral $ <br /> '�1 E4FRETT MA 98201 Tolal Conneclion Charge $ <br /> ��' Phone 2S2—o6Ae Utility Development fee I <br /> '�' Legal Description: Water S <br /> � ' Lot A �rH�ro Sewer $ <br /> � <br /> 1 Block Totai Development Fee $ <br /> ' Piat <br /> '� Unptatted Description: Sewer Bond District <br /> '�' Abutting Lot Line <br /> �' N, S, E,W K• <br /> �' Type of Permit CAP oFF Approved By <br /> Remarks Issued By flUG9ES <br /> i ' Customer Signature <br /> __ I IMPdRTANT! <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING �.��� <br /> Inspection By � �� / <br /> CALL 259-8810 FOR INSPECTION <br /> Date Inspected � �` - �'Z— <br /> SEE SKETCH ATTACHED No. 28533 <br /> ir�sPr_ci ioN <br />