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� <br /> r <br /> w <br /> everefl CHART NO. <br /> e <br /> c�ey ut e�a.ett ^� <br /> Sewer Application and Permit <br /> N0. Q516� DATE �O 11� 19BS <br /> Service Address— �71� ��tit � �� <br /> Utility Account No. <br /> Billing Address 2701 N�lnnt <br /> Permit Fee �.50 <br /> City, State, Zip �=stt, Na�hinqton 9gyp1 Connection Charge�s) <br /> Owner (Mortgagor�r i S LlwSetd 2.50 <br /> . Total Fee <br /> Billing Name <br /> Connection By <br /> Address_ Signed_ <br /> Phone <br /> 259-083< c��:tomer <br /> DESCRIPTION: <br /> �� �� Sewer District <br /> �0� Block 639 <br /> Plat Mt��,.» r-na e �, i� Monthly Sewer Service <br /> Unplatted Description Monthly Sewer Constr. <br /> Type Permit: r� pe�lition Trunk <br /> Lateral <br /> Remarks: � �11 nnita <br /> +Mbutting Lot Line � <br /> -- N, S, E, W tt. i <br /> _ �� �a � <br /> 1►. R. Theal j <br /> ��q// APProved By I <br /> L�O . <br /> O � CitYEnpmen � <br /> —____� — rl�MOw n <br /> Issued By s• ��nd <br /> — — / I <br /> 7-/ - f <br /> Inspection By I �" <br /> — Date Inspected i <br /> SEE SKETCH ATTACHED NO. �5160 � <br /> INSPECTION ' <br /> L � <br /> L - <br />