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. CHART NO. <br /> evereri ' ��T g o ��'t-tlVC,� <br /> � � 3/►'t/9� <br /> � � � � 8 <br /> City of Evereit � o .� <br /> i o 0 0 0 <br /> p� r', t•: I". P <br /> n� � N M <br /> Sewer Application and Pe�rrMt - <br /> .� � y I <br /> 5_ 4t 4: � <br /> 27528 �=' � � � w � <br /> N0. DATE �ihryaz�r 24'_ 19�0 <br /> Service Address ••�•+ ,-- --..� Utility Account No. <br /> Billing Address ��-- — Permit Fee �p,�� <br /> City,State, 2ip_ .��--i Connection Charge(s) <br /> Owner �Mortgagor) �!s E. nlount Total Fee 3p,pp <br /> Billing Name <br /> Connection By_ <br /> Address Signed <br /> Cuslomer <br /> Phone_ <br /> DESCRIPTION: Sewer District — <br /> lot Block Monthly Sewer Service <br /> Plat <br /> Unplatted Description Monthly Sewer Constr. <br /> ... . <br /> — Trunk <br /> Type Permit: Ner cornectiaa T�6 72 �� <br /> Lateral <br /> flemarks: <br /> Abutting Lot Line <br /> ;y, g. E, W ft. <br /> Approved By �*��n u_ mnFnr. <br /> City Enginccr <br /> IMPORTANT! <br /> sued By r-rg•*A�F �t� <br /> CALL1-800-024-555548-HOURS i <br /> PRIOR TO DIGGING <br /> CALL 259�8811 FOR INSPECTION � /, r� <br /> G' <br /> Inspection By � <br /> Datelnspecied�� `3 <br /> SEE SKETCH ATTACHED N�• �7J�o <br /> Ii;�P6C�i 10(V � <br />