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!Y!rlll <br />� <br />cNty ot Er«.tt <br />Sewer Application and Permit <br />No. 25342 DATE �r u• 1� <br />Ssrvice Address 4t�� �+�� r� Utility Account <br />Billiny Addras � 1� - bfL-�t 1t <br />City, State, 2ip �� � �e� — <br />Owner (Mortgagor) ��l�i» ����� <br />Billing Name +� <br />Connection By �� <br />Address i�x _ �+a ac_ r <br />Phone �c�u» <br />CNART NO._ <br />r �s-2s-a <br />���T ; o -,�_�� ; T�.�^L �ae/� <br />Permit Fee___�.�. <br />Connection Chargels) s7o-nn <br />Total <br />�r DN. TN orQ. 1171-�5 <br />ssa�ii. r..ur 11.de.eo. <br />Mwt 171.00 <br />1Mit+�s , 17l.00 � 6f0.00 ^ <br />Signed � % i , - .i.!G� -- <br />, c <br />DESCRIPTION: Sewer District — <br />Lot •�— B��k Monthly Sewer Service_ <br />Plat �1��� <br />Unplatted Description Monthly Sewer Constr. <br />Permit: <br />Remarks: <br />IMPORTANT! <br />CALL 1�800�4245555 48•HOURS <br />PRIOR TO DIGGING <br />CALL 269-8811 FOR INSPECTION <br />SEE SKETCH ATTAC.HED <br />Trunk s�e_ee <br />Abutting Lot Line <br />N, S, E, W, <br />Approved By ��[:.a _ �1 <br />aty eoo�oecr <br />Issued By <br />c ,o4�e/.N.4Y, <br />Ilnspectio <br />Date Inspected s� �'�� <br />No. 25342 <br />INSPECTION <br />