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CHART N0. <br /> eve�ett � <br /> e � `'_zs _n � <br /> � ,:,er� {� c a,`;�� <br /> � <br /> City oi Eventt � � q $� <br /> � . . <br /> � � �� <br /> S�wer a i ion and Permit <br /> � � <br /> � ��� _ <br /> No. 2764� DATE sar :a. i9so <br /> Service Address ����_�t Utility Accow�t No. , <br /> Billing Addr�ss »� d�� �_ __ Permit Fee �p,M — <br /> City,State, Zip sst� �u �s��� Connection Charge�s) — <br /> Owner IMortgagor) �w ��� Total Fee <br /> Billing Name " ' <br /> Connection 8y <br /> Address Signed � <br /> customer <br /> Phone – <br /> DESCRIPTION: Sewer District, nacth md <br /> Lot Block Monthly S��wer Service <br /> Plat <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk <br /> Typa Permit: <br /> Lateral <br /> Remarks: <br /> Abutting l.ot Line <br /> N� g, E, yy ft. <br /> Approved By �� ����� - <br /> Ciry Enyineer . <br /> IMPOHTANTI <br /> Issued By • *^��11 <br /> CALL 1�00424b566 4B•HOURS <br /> PRIOR TO DIGGING <br /> CALL 269�8811 FOR INSPECTION , /J� <br /> Inspection B�y �5��' <br /> Date l nspected ��"S—�v <br /> SEE SKETCH ATTACHED No. 27849 <br /> IfvSPCCTION <br /> I <br /> t <br /> � <br />