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CHART NO. <br /> everett � <br /> e � pppppppO <br /> S�iuT To Ci1.9.�r�%� '7 ��� <br /> � C� O In 4 O O O {f� y' `i <br /> City of Ewrett p.p � o�j w � Zy <br /> L� » W w M N M M � <br /> .� <br /> Sewer Application and Perm�.�.� . � � � � h � � �� � <br /> ✓ �,nl.. �/ g_ a � ;� � ;n . � c- <br /> /� '3a�s' � ms' <br /> No. 25638 DATE �— <br /> $ervice Address "'� "`�""` "'� Utility Account No. <br /> Permit Fee + <br /> Billing Address 27-- -" -f �M' — <br /> ����,,,�, _ Connection Chargels) <br /> City,State, tip <br /> pwner (Mortgagor►���d'lis"� Total Fee <br /> gp�eial lN. �sdi�nc� 1171-85 <br /> BillingName ��^�� • ���� wbr 179•00 <br /> M�= �71.00 <br /> Connectian By �1 / 6�• , ' ; ; <br /> Signed 1� / 1` .�� <br /> Addreu a :om.� � ,� <br /> Phone <br /> gewer District <br /> DESCRIPTION: <br /> � � p�st o! 10 Block <br /> � Lot� —�6T--- Monthly Sewer Service <br /> ' Plet <br /> � Unpletted Description � � Monthly Sewer Constr. <br /> � - Trunk <br /> Typa Permit: Mrv Cawo�ctlm Laterel <br /> � Remarks: Abutting Lot Line <br /> N. S, E W k. <br /> Approved By ��� �' � <br /> citY Enpinen <br /> IMPORTAN71 Issued BY w��t E' �t� <br /> �qLl. 1�OOd245555 46�HOURS <br /> PRIOR TO DIGGING <br /> CALL 259$811 FOR INSPECTION � <br /> L��-,��/ <br /> Inspection By� <br /> — Date Inspected i�' 3 " ��' <br /> SE[ SKETCH ATTACHED <br /> � No. 25638 <br /> I NSPECTI OfJ <br />