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everen <br />e <br />City of Evsrott <br />Sewer Appiication and Permit <br />No. 26339 DATE <br />Service Address ���s �.n.�.� <br />8illing Address '.�. <br />City, State, Zip �c.�..�.�t,�_�?0� <br />Owner (Mortgagor) r�.�.. -+..+M�- <br />Billing Name v.-- <br />Connection By_ s...e� c�.��...e,s,�� <br />Utility Account No. <br />Permit Fee l0 00 <br />Connection Chargels) <br />Total Fee �,p.,.00 <br />� , <br />:f ,. . -: 'j . . <br />Address ��� a_o�w � r� r�.�...��� me�p Signed- `_'�� :. --_ , � �;;•, j <br />Customer'� �° <br />Phone ��e-u+e <br />DESCRIPTION: <br />Lot <br />Plat — <br />Unplatted Descriptio <br />Permit: <br />Remarks: <br />6 <br />Block <br />� <br />IMPORTANT! <br />CALL 1�800�424•5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Sewer District <br />Monthly Sewer Service _ <br />Monthly Sewer Constr. <br />Trunk <br />Abutting Lot Line <br />N, S, E, W. <br />Approved By <br />�19r J i�7�6'W'f 11�t1�fl7S1S ft#�t <br />r <br />�es�ed sy �a�z�a_ <br />Sk'l�Tt #IO.UD <br />Cf�CI; �lU.M <br />Inspection By �� <br />Datelnspected ��7"�� <br />INSPECiION <br />No. 26339 <br />