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everett <br />City oi Everett <br />; . , I I ��� -4�1 <br />Sewer Application and P�rmit <br />NO. 2 R 2[ 6 DATE 1►Pril 2 3, 1991 <br />Service Address 11 - 113th St Ss <br />BIIIing Address 2190Y 3Alh 71w t+ <br />City, St8t8, Zip Ariar MA 980]6 _ <br />Owner _ f+��nt 8o�es <br />Connection by <br />Address <br />CHART NO. <br />�ir: .: ':1 �.�:I[!71 �Y�U7i11:;rA:1� i �'. �, <br />;tn,�:,�;: ��„ <br />•.i ix i :'ai.�w� <br />u�U�: � i �'.'�l.ni� <br />I i'; I, 1„!.{I. ll� <br />i�n[t� cirr;.ru <br />Utility Account No. itfan6'A""�1 <br />'+�:FA 1' i :O.lyl <br />19p'�ifl !;.-�1.I�J <br />I I'� 1-'� 4b`.A�.qU 30.00 <br />Permit Fee $ �_ <br />ConnectionCharge IJ�1i1'I� c;(�;_p[i <br />u(p��� �rl��`., <br />Trunk `-��$ ?'��-�M.��n_oe <br />Itl�iil t"„fi,iY� <br />Laterai I �'i I$', � :' �< <t� <br />tU�HkP176) <br />TotalConnectionChargp,�,;{� a��G; r.�30.00 <br />Phone 356-7�]S i�(�'F �'� <br />Utiliry Development Fee ,y-M-�. � ;i�.��� <br />LegalDescription; Water "������� s''u�'�pi�o <br />1171 `� .b�" _nn <br />Lot 27 — Sewer ���ya��=«� 471.00 <br />�.�Y�1lR illl'�,�b��50.00 <br />Block — TotalDevelopmentFee�.tY'[E tuu n_�wi' <br />Plat Meridi�n Pl�ca <br />Unpletled Descriptlon: <br />Sewer Band District <br />Abutting Lot Line <br />N, S, E, W <br />n. <br />Type of Permit N�w ooan�c!!on _ Approved By <br />Remarks — Issued By r�xnnret Kct.aod _ <br />IMPORTANTI <br />C!'.LL 1-800-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259•8810 FOR INSPECTION <br />SEE SKETCH AT7ACH�D <br />Customer Slgnature <br />�, � <br />hiroection By <br />Date Inspected � <br />INSPECTION <br />NO. ZHZ26 <br />