Laserfiche WebLink
i. <br />� everetl <br />�e <br />� <br />I <br />City oi Everer <br />' Engineering & Community Services <br />Sewer Application and Permit <br />N0. � ;_ I � �� DATE � � " %' 7 <br />Service Address � '% ? �- /��r.,: � J �J <br />Billing Address� v• /� .��C S'oJ 5 <br />CHART N0.'Y��—ZQ,—,j� <br />, <br />Po s T""L ,p �.: <br />Utility Account No <br />Permit <br />c�G , _'� ; . <br />City,State,Zip1'd��: <-ia��J �j��r:G�;;�✓ /7j�,y ConnectionCharge(s) <br />Owner (Mortgagor���%�%�'�i�i �" 5 /n��, ","otal Fee `7 G� �"'� <br />BiliingName =/-�;��,t <br />Connection By /,� /� <br />\. �` '" <br />Address Signed��� f'_-�,���� � <br />PhO�e_ _ Custo ner <br />DESCRIPTION: <br />Lot � � - -3 3 Block �' � S <br />P�at �' `rr" . i�� i i <br />Unplatted Descriotion <br />Type Permit: <br />Remarks: <br />< <br />� _ . <br />G `r;i:r iv r <br />i� <br />SEESKETCH ATTACHED <br />t� � <br />. ._ .. .. _ , -. .. ...M1 . „`y <br />SewerDistrict l�'r :� Tr-! r ��.� <br />Monthly SewerService Y' " Yc�,"��l` J <br />Montlily Sewer Constr. <br />Latera <br />Abutting Lot Line <br />N, S, E, W <br />i <br />Approved By s�Jr...-:,. <br />Ciry Enginecr <br />Lsued By. � . ,:`.'.r:, <br />Inspection B <br />Date <br />;i � : , �. N0. �I_ ! ;, <br />. . �,� . . , .. <br />� . .... ��. � �� � �, ' ➢�i ._r. r .. q\ . .-'� . <br />..... _ � _ ..vyl` �. . _ : e. <br />