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everett <br />e <br />Cky of Everott <br />I CHART N0. <br />%°�� E tt, <br />c,har �,ny <br />�/� ��`�� <br />S�ewer Ap�lication and Permit <br />No. 25391 DATE ___ <br />Servica Address �a 106th �l�p 6.�. <br />�7016 lith llwnot N.t, <br />Billing P�Idress _ <br />D�oa6�r 16, 1lBS <br />Utility Account No._ <br />Permit Fee ��•� <br />City, State, 2i s�t!]w, Ma. 9t1SS 330.00 <br />p! Connection Chargels) <br />vo Oeo�l. Ce. Iae. �0.00 <br />Owner (Mortgagor� _ Total Fee__ <br />8illing Name Otdieancr 1171-65 <br />Mabr 179.n0 <br />Connection By__ �72.00 ,. <br />' � 6SO.OQ j � _ <br />Address __ Signed � s-'" _ <br />c�nome, ' <br />Phone_ �6l�-0916 <br />DESCRIPTION: Sewer District �d Iti <br />Lot 7 Block Monthly Sewer Service s•SO <br />Plat �u iae� — — <br />Unpletted Descrip+.ion _ Monthly Sewer Constr. <br />Permit: <br />Remarks <br />IMPORTANTI <br />CALL tE00dT4�665548-HOURS <br />PRIOR TO D16GING <br />CALL 259A811 FOR INSPECTION <br />SEE SKETCH AT'fACHED <br />Tru <br />Lateral <br />Abutting Lot Line <br />N, S, F, W <br />Approved By �• R. 7fie�1 <br />Cny Eng�nr��r <br />Issued By _ E' �ona__ <br />Inspection l3y� <br />Date I nspw:ted_ � � � J /� <br />li;' Pi C1i�;P! <br />3�0.00 <br />No. 253y1 <br />_ft. <br />