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. <br /> � <br /> , . <br /> evere't i � � �'—` / j�� <br /> i <br /> � � � �� � ��� � � �:i '��' /5 �`=� -� �" <br /> Ci�y of Everer <br /> Engineering Depaitment <br /> S�wer �►pplication aeld P�rmit � <br /> � ;3'7A5 <br /> NO. L U / J �� DATE -- �— <br /> Service Address - - Utility i,�count No._ <br /> Billing Address Connection Permit Fee <br /> City, State, Zip Connection Fee <br /> Owner (Mortyagor)__ Tot21 Fee <br /> Billing Name <br /> Connection By_ — <br /> Address Signed� <br /> cu:romer <br /> Phone_ <br /> DESCRIPTION: Sewer District _ <br /> Lot <br /> Monthly Sewer Service .._ <br /> Blod< — <br /> Division or Addition_ Monthly Sewer Constr. <br /> Trunk <br /> Type Permit <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> Approved By <br /> City Engineer <br /> — Issued By ___-- <br /> Insper.:tion Ey x �04=� �rossy�b� .Q/"� <br /> Date Inspected � //—z �' ?Y <br /> 0 <br /> SEE SKETCH ATTACHED NQ• ', <br />