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i <br /> I\I �� - C , .� � _ � � CHART N0. I _ '� .�� `` <br /> evereri ; � , � _ ;� <br /> N,, � � � �� ���� <br /> � i � ' '% <br /> ; �/� 0� ; <br /> City of Everatt <br /> , J��� <br /> Sewer Application and Permit � <br /> No. 232�aD DAT� -- ----- - <br /> Service Address Utility Account No. o� <br /> Billing Addressl Permit Fee_ � � <br /> City, State, Zip_ __ ' Connection Chargels) <br /> . 3 � <br /> �°--".._ <br /> Owner (Mortgagor <br /> ' ��+�'_���� .Total Fee - ------ <br /> Billing Name <br /> Cunnection By <br /> i� <br /> Address_ _ _ Si��ned <br /> C.ustomer <br /> Phone ------------ <br /> DESCRIPTION: Sewer Dis�rict <br /> Lot�y�— Block��a�r Monthly Sewer Service — <br /> Plat - �y <br /> Unplatted Description - - -- Monthly Sewer Constr. <br /> ^ Trunk . <br /> Type Permit• ��/ [ f.x1.-c.a€�� <br /> Lateral <br /> Remarks: _ Abutting Lot Line <br /> N� 5• E� W---- ft. <br /> �__ Ap!,roved BY ����F�a�ei•� J <br /> — -- Issued By ---- � <br /> i / �� � <br /> Inspect�on Hy_�l._a�'"_�L�LtiNL�21— <br /> -- G' <br /> — Date Insp��cted_7-�`�� " 7 � <br /> SEE S'CE`CH ATTACHED N�� 23229 <br /> IIJ�i'CC 11(,�! <br />