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everetl <br />e <br />City of Ewrett <br />� Sewer Application an <br />No. 27539 DATE <br />r <br />�$ s S $ <br />. ��� � <br />.� <br />�"��� <br />����� � <br />� � <br />Service Addren Utilitv Account <br />Billing Address � Permit <br />City, State, Zip Conne� <br />Owner (Mortgegor) <br />Billing Name <br />Connection By ' <br />Phone_ <br />DESCRIPTION: <br />Lot Zp 4 Blxk <br />Plet +-•'-• --� <br />Unplatted Description <br />3 <br />Typs Pe►mit: <br />t <br />Remarks: <br />I PORTANTI <br />CALL 1 OOd245555 46•HOURS <br />RIOR TO O�GGING <br />:AL 259-8811 FOR INSPECTION <br />SEE SKETCH ATTACHED ���� <br />Total <br />CHART <br />� <br />Ot12itT Dwrinj�ut �w Ced. 1171-85 <br />wt�r t2i.00 <br />'�, ��t stl.00 <br />W <br />Signed �� � � ,; / =-- ,`\ <br />_. customw <br />Sewer District % ama I2 <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Trunk 470_00 <br />Laterel �SO.Oo <br />A6utting Lot Li�e <br />N, S, E, W ft. <br />Approved By ivt� t_ �►L <br />Ciry Enpineer <br />Issued By su��Baw�n <br />I nspection. <br />Date Insoe� <br />`'� r ' ! ,1 <br />,� , � <br />� <br />INSPECTION <br />No. 27539 ` � <br />