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CHART N0.—._.. <br />CVE'fCf1 <br />� <br />_� <br />, City of Evcrett <br />Sewer App�lication �and Permit <br />N0. 24176 DATE '/10/Lt2 _ __ _ I.. <br />' 419 7dth Stroet S.N. <br />I Servir.e Address------- _ __ _ -_ _ _ _ <br />02fi S.C. Tvorett Mall Huy <br />Billing Address------- ----------- - -------- <br />P.vezett, Na. 90201 <br />CitY, Stale, Zip-- ----_-- - <br />Gwner (Mortgagor) �tillis Ilomea Inc. <br />Billin,, Name Satno <br />� Connection By —_.-_-_ <br />Address _____ <br />Phone_ 355-d692 <br />DESCRIPTION: <br />Lot __ �� Block __.__ <br />Plat Veralene F.eteiae <br />Unpla[ted Description___ __ _.___ <br />---_.__ _ _ <br />Type Perrnit: New Connection <br />7G11�-1 <br />Utility Account Uo._ _- ___ __-_ <br />3U.00 <br />Permit Fee___._ _ <br />Conner,[ion Charqels) <br />30.00 <br />Total Fee_ _ __ _____ <br />Signed <br />SEE SKETCH ATTACHED <br />i � . <br />Aand II <br />Sewer District---__ _ __..-_ -_ <br />Monthly Sewer Service___._ 6.50 __ <br />Monthly Sewer Constr. <br />Trunk � • 15 <br />Latcral ___ <br />Abuttiny Lot Linc <br />N. S, �, W—. <br />Approved 8y h. R. Thnel <br />c��, Engmeer <br />�. Bond <br />Issued By _ <br />27�).UO <br />C � (. <br />Inspection By��-���� — <br />i � � � <br />Datc Insprcted_ . .�� __ . ���-�- -- <br />No. 2�1%6 <br />0 <br />