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�� � <br /> m � x <br /> C:, H <br /> � H5cn <br /> Hz�H �-�: -- -- --- -- --x---T-."—_.—"F'__'— --- - _ , .. .. � <br /> � y� � • CHART NO. � <br /> �ay� �, _. � <br /> � ; <br /> oy� _ T� p�ST�N i <br /> � � g � ,_ _, � �, � �w � =� .: - � � �/2_ ' <br /> �� o e, � , ,� � � , Q <br /> - � <br /> 'N�'M , ' ` . ' ` i `-' \� I <br /> � �� � �� � �� <br /> I � �� �' <br /> �-+ H 4 . � <br /> � � � Sewer Application and Pe,rr��t; � ,, . �:, : � <br /> O 5t7 V1 I� i r' �� r� , c .� f It �^ `i � W I <br /> C�1 :.. � ' . .S _c t � f.: <br /> ° "' � 9/8/92 - — <br /> �a � ` 23 �, .,7 DATE - _ . �I <br /> Service Address 5506 Parkview I.n Utility Account No. <br /> j Billing Address �����x�� 737 Fln St � <br /> ��st',�rLraKX�4YD4 F.v�ratr. 9820 70.00 <br /> City, State,Zip —�:� Permit Fee $ , <br /> Owner �a��'� Selecc Hnu�en Conneclion Charge <br /> � Connection by �^"�' �O' Trunk $ i <br /> �� <br /> ! Address Lateral $ ; <br /> I ' <br /> ; Total Connection Charge $ n nn <br /> 'i <br /> � 1 ! Phone Utility Development Fee <br /> ��� i Legal Description: Water $ 179.00 i <br /> � <br /> '�1 ! Lot 17 Sewer $ <br /> � � � Biock Total Deveiopment Fee $ 179.00 , <br /> '�1 I Plat }innabrook <br /> ' Unpiatted Description: <br /> Sewer Bond District ULID O1 <br /> � ; � <br /> � � A6utling Lot Line <br /> �� � <br /> ' N,S, E,W n' � <br /> � � <br /> Type o(Permit Nuv connoction Approved By <br /> ' GB <br /> '=� � Remarks Issued By <br /> i Cuslomer Slgnature <br /> '�; '�I IMPORTANT! , <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> Inspection By �'���'l�''= �''^ <br /> CALL 259-8810 FOR INSPECTION 3 y ,��3 <br /> Date Inspected <br /> SEE SKETCH ATTACHED ,� �r 8�� I <br /> INSPECTION -• <br />