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I evereq <br />e <br />a�y o, e�.�en <br />Sewer Applicction and Permit <br />N� 24078 '�18ie' <br />DATE _ <br />lO1S l0�th Pl�e• 6.E. <br />Service Address --- <br />l.O. fos �19 <br />Eilling Address <br />ttlrkl�nA, Ma. 9/0 » <br />City, Stete, Zip - <br />Owner (Mortge9or) sb���tad a Millia��. Iae• <br />Billing NTme 6��� <br />Connection By s��� — <br />P..;dress <br />e17-049� <br />Phona ---- ---- <br />DESCRIPTION: <br />Lot __ 11 Block_-- <br />Plat _ !it-E��r _---- <br />UnplettedDesaiption_---- — <br />. Type Permit Nw Conw�alioe <br />Remarks: <br />SEE SKETCH ATTACHED <br />CHART <br />��� �., . <br />,..., <br />Utility Account No._ <br />�0.00 <br />permit Fee_ <br />Connection Chargelsl_— <br />30.00 <br />Total Fee____— <br />ore!■ano• 71s-�o <br />�r�a 7 <br />76096-7 <br />]70.00 <br />»9.00 <br />76 AenA II1 <br />gewer Distrirt__--_ - — <br />6.50 <br />Monthly Sewer Service__ __ <br />�lonthly Sewer Constr. <br />r_._� �.�s a�o.00 <br />IN51'f C110N <br />Lateral_ <br />Abutting Lot Line <br />N, S, E, W <br />A. R. TREAL <br />Approved By c�w e�a���H <br />�. lOIID <br />Issued By - - <br />Inspection By��� � <br />� c'- S C�� T--� ��f� �-- <br />Date Inspected __. <br />NO. Z4O78 <br />