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everett <br />e <br />City of Everett <br />Sewer Application and Permit <br />No. 23298 DATE 9��'3n9 <br />Service Address 5203 11 a 8 South dth 14venna <br />2602 Pwcific Aoan�e <br />Billing Address <br />City, State, Zip �rett, Ma. 98201 <br />Owner (Mortgagor) «eig Oiuu�ep Conot. <br />Billing Name 4aiq B�mnep Cbnat. <br />Connection By ��iq Bunne7 Oonat. <br />Address 2802 Pacifie Awnue <br />252-2117 <br />CHART NO../� -32� Z9-`S <br />14A79 <br />Utility Accoun[ No. <br />Permit Fee 30.00 <br />Connection Charge(s) 1016.�0 <br />Total Fee 30.00 <br />Signed <br />Cusmmer <br />. <br />Phone <br />DESCRIPTION: Sewer District 16 Pond II <br />Lot �� Olock 1� Monthly Sewer Servi��=ed — <br />Plat �� of 7aw11 <br />Unplatted Description Monthly Sewer Constr. <br />Trunk 1•AD ]84.00 <br />Type Permit: Nnr ppnnection 3.60 032.40 <br />�—� La[eral <br />SEESKETCH ATTACHED <br />INSP[Cl'ION <br />Abutting_Lot Line 120 <br />�N.�. E, W ft. <br />Approved By !7. Warren i <br />Ciry Enginett <br />F.. Aond li <br />Issued <br />Inspection By Q+-R �- - 11�^'--f � <br />�' <br />Date Inspected � 4 n�C�%� ��� � <br />No. 23298 <br />