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everett <br />e <br />City oi Everett <br />Sewer Application and Permit <br />NO. Z340O DATE 1/+/80 <br />Service Address g�� lOSth Plao� B.E. <br />Billing Address �=Ol Culo�la _ <br />CitY, State, ZiP--��tt, Ma. 9820� <br />Owner (Mortgagcr) p��= ��_� <br />Billing Name p!�= �°r� <br />Connection 6y �01 1N,�tMr�d <br />Address _�N�_ <br />Phone �'�517 <br />DESCRIPTION: <br />Lot _ � Block <br />�'lat _ �wn ll�t /l _ <br />Unplatted Description <br />Type Permit: � p����p� <br />Remarks: <br />SEESKETCH ATTACHED <br />CNART NO._ � �� ��-� <br />P st�d <br />►;,�k a�o�k� <br />Z-1`�- g � <br />. <br />78B99-B <br />Utility Account No.__ <br />Pennit Fee �•� _ <br />Connection Charge�s) ��•SO <br />�0.00 <br />Total Fee <br />I <br />Signed_ _ i <br />cusmmer <br />iN���'I � 'iiir, <br />36 Bond III <br />Se�,ver District______ _ <br />Munthly Sewer Scrvicn_ 3�� _ _ <br />Monthly Sewer Constr. <br />T.....L 2.25 �)� 702.50 <br />Laterat____ <br />1butting Lot Line <br />N, S, F, W_ <br />Approved By H. Narnn <br />C��y Enp�nrer <br />5. Bond <br />Issued By ____ _ _ <br />Inspection By_.�.�+�` � <br />t <br />Date Inspected_ �_ _ `� 'S �'� . _ _ - - <br />N0. 2J40� <br />�\� <br />