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CHART N0. �' ��7-8-�' <br /> ever�n <br /> � =?, ... ,.,. �, <br /> J D// �'; <br /> � <br /> c�cy or e�e��tt <br /> � � - <br /> ; . <br /> Sewer Application and Perr►�it � <br /> No. 23224 DATE ---- --- _ _- -- ---- ------ <br /> Service Address �__��t� � Utility Account fJo. — <br /> / <br /> Billing Address / _ Permit Fee_ <br /> City, State, 2ip Con�ection Chargelsl_ �' � ' ~ —_ <br /> % - <br /> Owner (Mortgagor) _ = __ Total Fee-- _ - - _--_ _-_-- -- <br /> Billing Name ; <br /> Connection By __ __ <br /> Address Siyned_ <br /> Cutromcr <br /> Phone ' - --��1-�--�-- -- <br /> i _. - <br /> DESCRIPTION: Sewer District , <br /> —�--h_' --- — <br /> Lat '� Block_ — , <br /> Plat / Monthly Sewer Service_ --_ <br /> Unplatted Description ___._ Monthly Sewer Constr. <br /> - — Trunk <br /> Type Permit: ' <br /> �ateral <br /> Rem:rks: y r , � / <br /> --- -�-+-�i----. Abutting Lot Line <br /> N• S� E• W— - - -- it. <br /> - -- — APproved OY---— - ----- <br /> c�iv c��y,�„•,-•,_ <br /> —_ — ISSUC(� f3Y_____—__ .- . . — <br /> — --- -- Inspection BY,,;_� .' ('�------------- <br /> ___ ____ Date Ins ecteC �� l �� � � <br /> ----- _-- --- -- P U� � —.L—l------ <br /> SEE SKETCH ATTACHED NO. Z3ZZ4 <br /> INSf'LC11U!i <br />