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�aa_a \C.' YTQ -- :Y �;' � . L � v r . . r• l �j � .... . .. .. . <br />j <br />ICHART NO. _ <br />Sewer Application and Permit <br />�, <br />_ '" i _ _ "_y _ <br />TO POSTING � s-93 <br />29037 DATE %''3-'/3 I <br />(� C 2:� I_;,�vc�l 1'J. <br />Service Address 61P9 -f.olbg'Aca Utility Account No. — <br />Billing Address <br />City,State,2ip PermitFee $ 1�•�" <br />Owner �idenonA ascon �tor.,es Conn2ctionCharge /� <br />Connection by 7runk J $ <br />Address 3106 79U, nv�. !;r Laterai $ <br />Everecc �,A 98:05 TotalConnectionCharga $ <br />Phone Utility Development Fee <br />Legal Description: Walar $ <br />Lot Sewer S <br />Block Total Development Fee $ <br />Plat <br />Unplaued Description: Sewer Bond Dlstrict <br />Type of Permit <br />Remarks _ <br />oif <br />IMPORTANTI <br />CALL 1-800-424-5555 48-NOURS <br />pR10R TO DIGGING <br />�' CALL 759•8810 FOR INSPECTION <br />Abutting Lot Line <br />N, S, E, W n. <br />Approved By <br />.�,� <br />IssuedBy ' _. <br />CustomerSlgnaWro - ' <br />Inspeclion By —�/�`�— <br />Date In;pected �' 30' r' <br />SEE SKETCH ATTACHED <br />INSPECTION � � , E' 1 <br />