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---_- -— ------ --__ _ --- -- --- -- ---- ---- , . . -- <br /> ,- -:,_ _ �-x---:� , . --------- <br /> CHART N0. <br /> � � <br /> H <br /> � H TO POSTING ���-� �3 <br /> yH Ui <br /> �� � Sewer Applica�ion and Permit <br /> o � o `-. � , : : _' I <br /> hd N '�tl . . . _ <br /> �' ~ 293 %� DATE B/16/93 <br /> x <br /> � 5028 Bln Se <br /> O�-y+ b� Service Address - Utility Account No. <br /> N�c�'� Billing Address �� I <br /> � � � City,State, Zip �verect SvA 96203 __ pe�mit Fee $ 70.00 <br /> y y � �rnia Altrom <br /> i Owner Connection Charge <br /> g�y , , <br /> � � ConnecNon by o. 5��+�.�_ Trunk $ <br /> ''�' � I Address _ Lateral $ <br /> � Totai Connaclion Charge $ '"�- <br /> Phone Utiliry Development Fee <br /> Legal Description: Water $ _ <br /> C' Lot Sewer $ 471.00 _ <br /> � Block Total Development Fee $_"�1.00 <br /> I �� ' Plat <br /> ; Unplaried Descdption: Sewer Bond District <br /> � Abutting Lot Line <br /> � n. <br /> I � I N, S, E,W — <br /> I, <br /> � Type of Permit :9ew conneceion Approved By <br /> I � ' oh <br /> � Remarks Issued By <br /> _ Customer Signature , <br /> �1 IMPORTANTi <br /> CALL 1-500-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> / <br /> Inspection By o����"'�" - <br /> � CALL 259-8810 FOR INSPECT{ON <br /> Dato Inspectod �-z`�'y � <br /> ' SEE SK=.TCH ATTACHEQ <br /> INSPECTION �� y 3 �Q <br />