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everet� <br />� <br />City of Everett <br />Sewer Application and Permit <br />No. 25107 "`Y e, i'es <br />DATE <br />�118 56th StsNt S.N. <br />Service Address __ <br />Billing Address 10108 53rd 71wau� 11��t <br />City, State, Zip �=Kt, Ma. 98201 <br />Owner (Mortgagor��� asigns LW. <br />Billing Name Sw <br />Connection <br />Pho�e 3�7-7J63 <br />DESCRIPTION: <br />Lot 18 Block <br />Plat �u�� <br />Unplatted Description <br />Type Permit: Nw �onn�ction <br />CHART N0. <br />.SE•vr ic, Ci�9�r..c%G �z9�1f6 <br />Utility Account No. <br />Permit Fee 30.00 <br />Connection Charge�s) ���•� <br />Total Fee_ 30.00 <br />a�rasoar: , eeoo.00 <br />SEE SKETCH ATTACHED <br />iNSrECTIQ�' <br />Sewer District � =I <br />Monthly Scwer Service <br />Monthly Sewer Constr. <br />270.00 <br />Lateral <br />Abutting Lot Line <br />N, S, E, W. <br />Approved By �•R• Theal <br />City Engineer <br />E. Ed.td <br />Issued By __ <br />Inspection By �� v�'`�'E'�siy.� <br />Date 1 nspected__ �'� r' b' 3' <br />No. 2g10T <br />