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, <br />everett <br />� <br />City of Everett <br />Sewer Application and Permit <br />Octobar 13, 1980 <br />NO. 23%77 DATE <br />5101 Nilaintoa 11��nu� <br />Service Address <br />Billing Address <br />r.0. Box 592 <br />Lake Ste��ns, Ma. 98258 <br />City, State, Zip <br />M�lu= � ��ith <br />Owner (Mortgagor) <br />sa�• <br />Billing Name <br />Sa�a <br />Connection 8y_ — <br />DESCRIPTION: <br />- - BZ <br />Plat _ <br />Unplatted <br />Tvne Permit: <br />]3�-606� <br />Block Clar�aont <br />N�v Conn�etion <br />CHART N0. � � " Z4 �5 <br />Utility Accou�t No. <br />50.00 <br />Permit Fee <br />Connection Charge(s) <br />30.00 <br />Total Fee <br />ordiaanc• 669-80 <br />11r�a I 221.00 <br />Signed <br />Sewer District <br />Monthly Sewer Servicc. <br />Monthly Sewer Constr. <br />Trunk <br />SEE SKETCH ATTACHED <br />INSP[CTION <br />Abutting Lot Line Northand <br />N, S, E, W <br />Approved By <br />City Engineer <br />Issued <br />Inspection By '� � — — � <br />Date Inspected / /'� �� <br />No. 2377T , <br />