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i <br /> CHART N0. <br /> � everett <br /> e �_ <br /> � <br /> City of Everett - L`� `� 8 � � � .`� <br /> '� ' � �i � �� � ? � <br /> � } M � M y1 <br /> Sewer Ap�,lication and Permit �J _ f� � � � � _" <br /> O � � L +i m W � <br /> NO. 26`522 DATE <br /> Service Address 305 109th 6t. Pl. SS , Utility Account No. <br /> Billing Address 191� N 34th i107 Permit Fee +n,pp <br /> � City,State, Zip 8aattl�, MA 9810] Connection Charge�s) �g5 n� <br /> Owner (Mortgagor) �+�� Total Fee +n a� <br /> Billing Name �m Spectwl Otllity T�e ard. 1171-85 <br /> wter 179.00 <br /> Connection By s� _ s�a�v�er �71.00 <br /> Address � Signed � . 6��;�,�/ ` `/'" <br /> Cmlome� <br /> Phone 5�7-8211 _ _ I <br /> � DESCRIPTION: Sewer District <br /> n I <br /> Lot � Block -- Manthly Sewer Service _ <br /> Plat <br /> Unplatted Description Monthly Sewer Constr. <br /> I <br /> i <br /> Trunk <br /> Typa Permit: 3 5.00 <br /> lateral <br /> Re;narks: <br /> Abutting Lol Line <br /> N, S, E, W ft. <br /> Approved By i <br /> IMPORTANTI � <br /> Issued By <br /> CALL 1�BOOd24�5555 48�HOURS � <br /> � PRIOR TO DIGGING ' <br /> I � <br /> I C:,LL 269A811 FOR INSPECTION " " . <br /> � Inspection By ��"- � <br /> 2I �', <br /> -- ----__ -- --- Date Inspected J`� '— --- <br /> SEE SKETCH ATTACHED Np, Z65ZZ <br /> Ili!GPLC7i(?�s I <br /> � <br />