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CHART NO. <br /> everett <br /> � �lv�� �e (',�i'.i:¢ii.�y <br /> C <br /> City of Everen �" `� �� <br /> Sewer Application and Permit <br /> rio. 26363 DATE ��t�' 1987 <br /> 51�U <br /> ;.�rvice Address � �� �►� Utility Account No. <br /> Billing Address 5077 - ]�rd 1►�e M Permit Fee_ ]0.00 <br /> City,State, Zip R�r�s�tt,f� NA 9820] Connection Chargels) 270•00 <br /> Owner (Mortgagor►�,�} -..-.-•__ Total Fee ��.� <br /> BillingName �_ .� BD�la1 Otilitr �a�, Ord. 1171-�Si <br /> watar 151.00 <br /> swar � '��n•.uU <br /> Connection By e--- - — SS2.o0 <br /> Address Signed_ .J� " '_� -� __ <br /> / � customer <br /> Phone gyg��� <br /> ! DESCRIPTION: Sewer District eond II <br /> lot y Block �. <br /> Plat Monthly Sewer Service <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk <br /> Typa Permit: <br /> Lateral <br /> Remarks: <br /> Abutting Lot Linq���l�� iUflb{iM OOtWl17�03 Y:Y1t <br /> N, S, E, W r ft. <br /> 110001 H1llr., <br /> !A_DG S.'�/1.0(1 <br /> r�.i,u sza.00 <br /> ri:CH fb.."A <br /> Approved By ��R. �f8 <br /> �,G�pinea f3.'SO <br /> IMPORTANTI t�=�� <br /> Issued By M�t as��od <br /> CALLI�BOOd24-655548•HOURS �W� I� �� � <br /> PRIORTODIGGING 11i1� '�� <br /> CALL 269A811 FOR INSPECTION �k�� ' � <br /> f / '�rHO� <br /> Inspectio� By— <br /> Date Inspected °��"��,�— <br /> SEE SKETCH ATTACHED ����� NO�1���Q�363 <br /> IfV�P[CTION <br />