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CHART N�. <br /> everefl — — <br /> � Sf�ir rv 1�-e._ _�,,� i <br /> ��ac r�d� <br /> �- .li -�'7 4 <br /> � <br /> CILY O1 EVQIBLI I <br /> I <br /> � Sewer Application and Permit ' � <br /> --1 <br /> n <br /> No. 25419 DATE � �� m <br /> � / �� <br /> Service AddressZ`-���_��E �l�f-Utdity Account No. �^m <br /> �� /+� v <br /> BillingAddress,�5�/ y�-�"�\ Permit Fee f(J �— i '^c9� <br /> City,State, Zi���1�� �� �nnection Chargels) �� <br /> Owner (MortgagoR)L(L�'A 4 � � �Q � m.�. <br /> � /►�,�_ Total Fee Q= <br /> i <br /> e `T% , �19,a�'6.� � _ <br /> Billin Name L h a I <br /> .�., <br /> <�' <br /> Connection By ' I � <br /> I o� <br /> ,� r , �,c� <br /> � Address�� �KTr,� Signed , f/ � �.�'' " i. o .;,�. i i ✓' I = <br /> I //� ��''�� 7Q �+�^ cwtomer � I m... <br /> Phone <br /> f3��� � �L(' � J� �/ � <br /> om <br /> IDESCRIPTION: ! � L�, <br /> Sewer District I r3{, <br /> � Lot Block �m <br /> Plat Monthly Sewer Service <br /> i � <br /> Unpletted Description Monthly Sewer Constr. _ <br /> D <br /> Type� Permit: _ — Trunk i = <br /> Lateral � �+ <br /> Remarks: � Y <br /> 0 <br /> y�— Ahutting Lot Line I � <br /> A.t. S o-. Co.c c� N. S. E, W_ ft. � r"" <br /> _�/ Pvc � <br /> Approved By_ ! � /. . ,' / <br /> aw eoyio.« �, <br /> IMPORTANTI <br /> CALL 1�600-024•655548•HOUqS �ssued By_� � � � - � <br /> I PRIOR TO DIGGING i <br /> CALL 259-8811 FOR INSPECTION / � <br /> __ _ _ _ Inspection B � �bP�//i4r! _ I <br /> i — — _ Date Inspected_�'y� �8 � i <br /> SEE SKETCH ATTACHED Np, 2541;'] <br /> I I <br /> li��" I,i r �l l� �; � <br />