Laserfiche WebLink
evereK <br />e <br />City of Everstt <br />Sewer Application and Permit <br />No. 26563 DATE w� 7. 1ls9 <br />Service Address 1l2S Ylyhlmd 1►w <br />Billing Address � <br />City, State, 2ip ��t• � �01 <br />Owner (Mortgagor) �� � <br />8iliing Name � <br />Co�nection By <br />Phone =�—�� <br />DESCRIPTION: <br />Blu�k <br />CHART <br />Utility Account No. <br />Permit Fee__ 10.00 <br />Connection Chargels) <br />Total Fee 10 00 <br />Signed <br />Customer <br />Sewer District <br />Monthly Sewer <br />Plat <br />Unpletted Description Monthly Sewer Constr. <br />Typa Permit: <br />Remarks: <br />IMPORTANT! <br />CALL 1-800�324-5555 48•HOURS <br />PRIOR TO DIGGING <br />CALL 259�8611 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved By *-+�o �- '�'�� <br />Ciry Engineer <br />Issued By ���°t E llciwod <br />Inspection By � <br />Date I <br />li?:_�i �C-,lGiv <br />� / 7 —j� <br />IVO. 26�V3 <br />