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CHART NO. <br /> everetl I ,� r, /`' sETIT To �o$tlNy <br /> e �,�4� <br /> � ; ;6,�� <br /> � ,•,,. <br /> City of Evic ett <br /> Sewer A�plication and Permit <br /> NO. ���o� DATE �yr �t ,oao <br /> Service Address 7a2� w_ c1.e er_ Utility Account No. <br /> BillingAddress soi� s�ch pi_ m_ wKt:�acrYroIIt�ermef�ux +0 00 <br /> City, State, Zip �..k►ic.�. e qaz�s Connection Charge(s) 130 00 <br /> Owner (Mortgagor) n.,�n. s+.�c�. Total Fee 30 00 <br /> Billing Name �... c.... Utility D�w2opa�nt !�a Ord. 1171-eS <br /> ratez 179.00 <br /> Connection By v.. sarer 471.00 '� <br /> 650.00 ' <br /> � <br /> Address s... Signed � ' %-�- � �� _ <br /> Customer <br /> Phone 353-6606 <br /> DESCRIPTION: Sewer District �g�� _ <br /> Lot 22 Block <br /> Plat e..*�.n c1.n Monthly Sewer Service <br /> Unplatted Description Monthly Sewer Constr. <br /> Type Permit: -- Trunk 310.00 <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> Approved By <br /> itV npineer <br /> IMPORTANT! <br /> Issued By �•.a; taaagon <br /> CALL 1�800a124•5555 48-HOURS <br /> PRIOR TO DIGGING <br /> CALL 259-8811 FOR INSPECTION ,q � <br /> Inspection By ���� <br /> Date I nspected -� "�-�O <br /> SEE SKETCH ATTACHED N0. 2718Z <br /> li\SPECTION <br />