Laserfiche WebLink
--- ) Yr�--T-----� �(� --,-- -- - - � ,- - -- -, --� -_ <br /> _ , _ . , . :-_-- <br /> "y " <br /> � __. .-r-•-___ . .. ,.. . ,�..,... . . .. <br /> _`-1� ;.�p�n�+f� 4h��"l6n<� d7�....,�i . ., <br /> CHART NO. <br /> � � � <br /> I <br /> � �� <br /> � <br /> TO PnSTING__g 1p�� <br /> � � � wer A lication and Permit '. <br /> ��� Se pp � <br /> 'tl�� <br /> "d ?. ?0 7 7 DATE �z->>-9� <br /> �x� <br /> C <br /> Service Address z93� n.il:':^ Av�� Utility Account No. � <br /> p� g I Billing Address i <br /> � y Ciry, State,Zip <br /> E�ereec NA 9a201 PermitFee $ Lr,nO <br /> � y I Centrun Financ:ial �rrvic.•s ConnectionChargc <br /> Owner <br /> ~ I $ <br /> � � Connection by Trunk �- <br /> �� i Latersl $ <br /> Address <br /> G0 i Total Connection Charge $ <br /> � phone 62S—SGJ 1 Utility Dev�3lopmenl Fee <br /> Legal Description: Wa�E� $ <br /> � C' �, Lot Sewer $ <br /> � ; B��k Total Development Fee $ <br /> I� Plat <br /> I �� � Sewer Bond District <br /> I Unpletted DescripUon: <br /> � Abutting Lot Line <br /> �I,� N,S,E,W ft. I <br /> � <br /> Type of Permit �nP �� ' Approved 6y <br /> �� Remarks Issued By <br /> i�s!omer Signalure ; <br /> u1 IMPORTANTI <br /> I ' <br /> ICALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING � �,�d., <br /> Inspection By�� �� <br /> CALL 259-8810 FOR INSPECTION ��� 7 � �j <br /> Date Inspecte� <br /> ��2 �—�3-93 <br /> SEE SKETCH ATTACHED � a�.�� <br /> INSPECTION <br /> i <br />