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"' \ <br /> CHART NO. L 20- Z 9 - 5 <br /> everen ' I <br /> e <br /> c�cy or e�a.ett �� <br /> 3_25.gt <br /> Sewer Application and Permit <br /> IN0. 23H6S DATE 1/29/dl _ <br /> ( Service Address Z 312 Hak�r Jtility Account No. <br /> HOA� <br /> Billing Address Permit Fee — <br /> City, State, ZiP_ Connection Chargels)_ <br /> � <br /> Owner (Mortgagor) <br /> Total Fee A��� � I <br /> I <br /> Billing Name I <br /> Citr ot E��r�tt � <br /> Connection By Don Nill�r <br /> Address_ Signed__ a���ome� <br /> Phone — — - <br /> DESCRIPTION: Sewer Distrirt <br /> Lot _ Block Monthly Sewer Service_ <br /> Plat <br /> Unplatted DescripGon __--- Monthly Sewer Constr. <br /> -- — Trunk i <br /> Type Permit: <br /> � <br /> Lateral <br /> ' -- i <br />�; i Remarks: REPAIR — Abutting Lot Line I <br /> � . ,, ,_ ' � . i � ,, ,.. � ' /.,. N, S. E, W — ft. I <br />�; , --' ' � <br /> /- i/�� //.��. f i/�. /� iirw �.. � ��i . . ; i • � � I <br /> i ,�'/ �� .S� �li <br /> tf. Bourhey <br /> — - Approved By_ � <br /> Ci�y Eng�.nccr i <br />� <br />� F. Bond <br /> Issued By i <br /> I — � <br />�{ � — — i <br />'� � <br /> I '— ' Inspect�on 3y _ • /� J//;, • f1"—� <br /> I -- / <br /> � -----------— <br /> i Date Inspected� ' �� - ' � -- <br /> I. —— —----- -- <br />� I SEE SKE?CH ATTACHED NO. 23H6S <br /> iINSPLCTIUN <br /> 1 <br />� <br />