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,` <br /> -, <br /> � <br /> CHART N0. n � -Z�� <br /> I evereri <br /> � ' I <br /> , .{ Pc�sst�i� 9 - �9-go � <br /> City of Evereft<ti �� � <br /> :- ,�� � I <br /> Sev�er� `� li�ation and Permit I <br /> ti �p:, . , I <br /> v �-.� DATE G � I���l'7 <br /> No. 23s3i :.. . <br /> . .�s � -��� � � <br /> `S�.(�y y ij�� f . ,.,,__,�( G!-c< �. Utiliry Account No. �v � <br /> Service Address_ � o � <br /> � <br /> , 0 Permit Fee �� o I <br /> Billing Address — <br /> � City, State, Zip=�� '� ���� �'��3 Connection Chargels�� '�� I' <br /> o'_ <br /> }'j;, , �i1,.� � _ -✓ Total Fee � �� ! <br /> Owner (Mortgagor) ' <br /> li ' <br /> � . <br /> � BillingName '-'"" <br /> I <br /> ' Connection By � <br /> I � : <br /> Address Signed c�s�ome� I <br /> I <br /> IPhone � � <br /> DESCRIPTION: Sewer District � � ��� I' <br /> �oi / Block Monthly Sewer Service�<�� 1'� <br /> I Plat �fyf�/7c % — / - �% I <br /> I Unplatted Description Monthly Sewer Constr. <br /> i <br /> I Trunk �1' �S � <br /> Type Permit: �' � <br /> Lateral z 75 � <br /> � � ���� �� <br /> Remarks: Abutting Lo[ Line <br /> N S E W it. I <br /> I <br /> I I <br /> II !� <br /> I <br /> APProved By�� � �`''� <br /> City Enginccr � <br /> � ,7 ' ' f I <br /> �: �,�,�� � , <br /> Issued By � <br /> I <br /> I , <br /> � Inspectio - <br /> IDate Inspected ��� �� <br /> ISEE SKETCH ATTACHED No� i 3631 <br /> , <br /> WSPECTION , , <br />