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� <br /> a- <br /> CHART NO. <br /> everen <br /> � C <br /> � <br /> City of Eventt $ g$ <br /> � O O O <br /> �w M M N <br /> Sewer Appl'�g cnd Permit <br /> No. 25866 a � T� � r ,_. - � - � , <br /> Sarvice Address�������/�-y �,�� Utility Account No. <br /> r� <br /> Billing Address Permit Fee � � <br /> City,State, Zip � � � !r Connection Charge(s) <br /> � � <br /> Owner (Mortgagor) �` :r i 1 / ��N�r f'r Total Fee I � <br /> Billing Name '- �� b <br /> Connection By � i' v�.� , 1' ,.� ( . ,`r �- � <br /> n// / �! <br /> Address �`< <��, li�i � ..: �..r 1��.:_ Signed �l . %'. ,l 1.�- .� .��� <br /> � � , , c��o�„e. <br /> „< <.y�� ,t+ � �� � � �,� 7 �' � <br /> Phone <br /> '�ir�� ` � �J7 1 � <br /> DESCRIPTION: Sewer District <br /> Lot � T +� Block ����� 5 <br /> Plat__ r., ,.i��.��.� !,,, ! C._l i ;i r (; _ Monthly Sewer Service <br /> UnplettedDescription V:� rN��,.. . %,� �;-� i :':� MonthlySewerConstr. <br /> Typa Permit: � Trunk <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> APProved By /!�'' �L�� % 1� . ,,�L_ <br /> Ciry Enqineer <br /> IMPORTANT! � � � <br /> Issued By �• /: f: �,;; r� . E� i..1i <br /> CALL 1-800�4245555 48•HOURS • T <br /> PRIOR TO DIGGING <br /> CALL 259-8811 FOR INSPECTION <br /> Inspection Byr� ��Se/M�� <br /> Date Inspected �� -��-K <br /> SEE SKETCH ATTACHE� NO. 25866 <br /> INSPECTION <br />