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CHART N0. <br /> everen <br /> e .����� 9��_8B <br /> City ot Erarott <br /> Sewer Application and Permit <br /> N0. �v ` O� DATE 1Y�,r ��. 19se <br /> Service Addreu�s�� Utility Account No. <br /> Billing Address �T21 1L� ae_ ss Permit Fee �o-ee <br /> City,State,Zip �t+tt r� 9i2ae Connection Cherge�s) 6be-oo � � '— <br /> Ow�nr (Mortgagor) csat v patntteQ Total Fee �o-� <br /> Bllflng Name s� _ �uL Utilil� !N OM. l�t 1171-lS <br /> Mrt.�r 174.00 <br /> Connecticn 8y i..■ Nv� �71.00 <br /> 650.00 <br /> Address n... Signed � <br /> cwtomer � <br /> Phone +** +1�-�LS� <br /> DESCRIP710N: Sewer District <br /> Lot Block Monthly Sewer Service <br /> Pl�t <br /> Unpletted Description Monthly Sewer Constr. <br /> Trunk u'!:7/BB�A���2W1 UOOAMtld02 Lttt <br /> Typa Permit: —� �� <br /> Lateral "��''ro�� <br /> Remarks: � �SS'� <br /> Abutting Lot LineK� f5p,� <br /> N, g, E, WI� rw ��v,6,2 n. <br /> D £RCH t1.� <br /> E SR.L}I �15.01� <br /> LN'VW`1 420.0(1 <br /> ilOQ�l�if19A <br /> Approved By_JY1��1-�■•* — <br /> IMPORTANTI �k ��•� <br /> �ssued By �y��p �� <br /> CALL 1-000�424b656�8•HOURS t�q�_g «p,�p <br /> PRIOR TO DIQOING q#:Clt {151 .!� <br /> CALL 269�8811 FOR INSPECTION % <br /> Inspection By — <br /> Datelnspected ��BB <br /> SEE SKETCH ATTACHED Np, 26701 <br /> INSPECTION <br />