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E A_ .. <br /> � ._..r, . � <br /> ...L. - : <br /> ._ ..._ {$ <br /> � �:�4.r:. :.^�..'��.�e-._ .. . . � <br /> ; CHART N0. « <br /> ��� 5_Z� -�3 <br /> � ' T4 POSTING__---- <br /> r��' <br /> " " Sewer Application and Permit <br /> � �� . <br /> � vHi� 4/28/'i3 <br /> � � 2 717 4 DATE <br /> y� 1532 Onkes Avo Utility Account No. <br /> � �ey Service Address <br /> O <br /> z�� Billing Address s �D.00 <br /> � H y Ciry, State,Zip p rr ua qs�n� — Permit Fee $ <br /> g �y Owner Connection Charge <br /> D�::ll PlunbinF TrUnk $ <br /> � t��" Conneclion by — <br /> �3 ,���, as.,. „� �i Lateral $ <br /> O t�i� Address <br /> --'--- Lwer�tc �A 9H2O5 Total Connection Charge $ <br /> Phone 335-1254 Utility Development Fee <br /> Legal Description: <br /> Water $ <br /> Sewer $ <br /> �, Lot <br /> ""'� Total Development Fee $ ' <br /> Block <br /> � <br /> I�� Plat <br /> Unplaried Description: <br /> Sewer Bond Dislrict — <br /> Abutting Lol Line <br /> �p ft. <br /> N, S, E,W <br /> � Altnrntio�i Approved By <br /> �.„� Type ot Permit ,� _ <br /> Issued By , � � <br /> Remarks �',��7-F-- <br /> �'�= Customer SlgnaWre <br /> IMPORTANTI <br /> � CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING ��J`/' <br /> Inspection By <br /> CALL 259•88�O t�OR 1NSPECTION Date lnspected 5 'y 'j <br /> SEE SKETCH ATTACHED INSPECTION ?9 = ` + <br />