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- . ` - <br /> �% <br /> �, <br /> CHART N0. � r�/'2Q-S <br /> � everen _ , <br /> � <br /> � �ostED <br /> City of �veratt �{-�•�� <br /> Sewer Application and Perm�t �8 <br /> No. �3747 DATE �/��/�� <br /> Service.4ddress � �� Utility Account No. <br /> ,`� ✓�_ <br /> , <br /> Billing Address Permit Fee � <br /> City, Sta;e, Zip Connection Charge(s) a <br /> � /� ��---- <br /> Owner (Mortgagor) � - c7�otal Fee <br /> � <br /> Billing Name � ' <br /> Connection By �. .-�� ( �� �x� - <br /> � . - - ,'` � <br /> i , <br /> Address _ Signed � ' " " c�sm�,�� <br /> Phone ��/� — ���� - <br /> DESCRIPTION: Sewer District — <br /> Lot3G '����� Block��— MonthlySevaerService <br /> Plat��• '�7� <br /> � Unplatted Desc-iption Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: nl.C� <br /> � L.ateral � <br /> � <br /> Remarks: Abutting Lot Line <br /> � —Y N S E W ft. <br /> , <br /> Approved By,1� " ��"� / I <br /> Ci':'Engincer <br /> ) li <br /> Issued By � — I <br /> __ I <br /> � � <br /> - � <br /> I <br /> % - J Inspection By��Pn� •- — <br /> ; �Uatelnspected 1(� i� � � i <br /> j SEE SKETCH�Ai'TACHED N�• 23Z47 I <br /> � � <br /> � INSPECTION I � <br /> � _ <br /> i <br /> �- J <br />