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evere„ <br />� <br />City of Eve►ett <br />Sewer Application and Permit <br />No. 25364 onrE _ _ i:no�ss <br />i:s s�cn oi.a. s.a. <br />Service Address Utility Account No,_ <br />Billin AdJress_ 1�=� ��> >0.00 <br />9 Permit Fee <br />City, SWte, Zip MMt. Ma. 98201 <br />Owner (Mortgagor) �� �it� <br />Billing Name_ <br />Connection By_ <br />Phone �5�-116i <br />DESCRIPTION: <br />Lot 10 Block <br />r�ec waiii Naeer <br />Unplatted Description _ <br />Type Permit: <br />Remarks: <br />IMPOFTANTI <br />CALL 1�800a24�666548�HOURS <br />PRIOR TO DIGGING <br />CALL 269A811 POR INSPECTION <br />SEESKETCH ATTACHED <br />Connection Chargels) »o•� <br />Total Fee �'� <br />CrAie�ww 1171-Bs <br />Mal�: 22A,OU <br />Nwr S6f.0o <br />813.00 <br />Signed <br />cwlomr• — — <br />Sewer Dislrict 9oeA III <br />Monthly Sewer Service <br />__ __ Monthly Sewer Constr. <br />' Trunk <br />Abutting Lot Lfie <br />N, S, E, W <br />770.00 <br />i�pprov=d By_11. A. lfi�al <br />Ciry Enpinea <br />Issued BY E. lond <br />Inspe�:tior' ) �� <-�`^� _ <br />_ Data Ins�ected � l� S I�P ___ <br />No. 25364 <br />i' ., �;Ilt. i <br />