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eV=�M CHART N0.-1� �t9 - ?9 - �� _ <br /> e � <br /> City of Evsrett ' 7��1 <br /> i�� <br /> Sewer Ap�plisation and P;�rrnit � <br /> NO. 24896 DATE <br /> ��3'��9Fd---- <br /> Service Address _ Utility Account No. <br /> Billing Address Permit Fee <br /> City, State, Zip Connection Charge(s) • <br /> Owner (IViortgagor) Total Fee <br /> Billing Name � <br /> Cannecxion By <br /> Address._,�_�v� Signed_ � ' %� %; <br /> �-rr�ry5v'Itt�- , �..�.._ <br /> Phone. '/ c�scomc,� <br /> DESCRIPTION: Sewer District <br /> Lot Block <br /> Plat Monthly Sewer Service_ <br /> Unplatted Description Monthly Sewer Constr. <br /> o s , , , o p�k 713 <br /> � n <br /> Type Permit: — Trunk <br /> pe <br /> Laterel <br /> Remarks: <br /> Abutting Lot Line <br /> N, S� E, W ft. <br /> � O ��HJ.00�G�D�. <br /> �v��J '� <br /> Approved 8y <br /> inccr — <br /> Issued By�f���_ <br /> Inspectior By <br /> Date Inspected <br /> � SEE SKETCH ATTACHED NO. 2Q.��96 <br /> INSPECTION <br />