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f <br /> � � � <br /> H <br /> C H <br /> � �� <br /> .. --- ---�-----� -------�- -�--- �r <br /> �..T------- : <br /> HH � . _„ - - � . <br /> tC y� r----- ...�� :. - .. .._. . . � � - ��. <br /> yy H , CHAFLT NO. <br /> � x � � ,= ,, � �`' �� ��flie�„ ' <br /> o� d '- <br /> �� g �/z_�,777 ' <br /> H� � � .. � f5 '�� -: .. i-. :"; � ���. <br /> 2aH � n : ; •-, � �� %� � <br /> r y [iJ ti M �-+ :C. i <br /> y y �� � '^ �. "� :r:. <br /> �j <br /> ��� Sewer Application and Permit ; � � � �. <br /> . ,., �, � W ._ <br /> , � . �. � , �- �:; <br /> � <br /> ZH(A .... .. .. . . .. . _ - i <br /> y o v, ^ ��; � :. DATE 9ifi/92 I <br /> Service Address 5510 Parkview Ln _ Utility Account No. <br /> wmvngHg��¢g �37 F.lm St _ <br /> Billing Address <br /> Permit Fee $ _ 70.OG <br /> �. City,State,Zip �sb��+^K�`�`^Y;tAaAPxx F.vecetc 9A2o3 , <br /> Eaii3iU3iRx.�CEiiN sclecc ticm��� 1n� Connection Charge <br /> Owner I <br /> Connection by J^�/ �O Ex ��r.�. Trunk � i <br /> Laleral $ <br /> Address 0.00 <br /> Total Connection Charge $ <br /> 1 ' Phone ___ Utility Development Fee <br /> �' Water $ 179.00 <br /> '�' Legai Description: <br /> ' f Lot <br /> 16 Sewer $ <br /> � Total Development Fee $ 179.00 <br /> �f1 � Block <br /> ' ' PI81 __ Hannlrook <br /> ULID 61 <br /> Unpla:ted Description: Sewer Bond District <br /> ' Abutting Lol Line <br /> I N,S, E,W n, <br /> � I <br /> ��1 � Type of Permit Ivew connc+ctioa Approved By I <br /> ' GB <br /> � Remarks Issued By i <br /> '-' Customer Signature <br /> �� IMPORTANT! <br /> CALL�-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING �� � <br /> Inspection By <br /> c �v��.c,�.. <br /> CALL 259-8810 �FOR INSPECTION Date Inspected 3"- � � ��� ' <br /> SEE SKETCH ATTACHED o ;; �c�a <br /> INSPECTION ' <br />