Laserfiche WebLink
�����-��� r�-���� . �. <br /> _uv��r►R,++c� ��:-rr,rN,--•��,� <br /> � � CHART N0. _ � � <br /> . ��0 POSTING 3�30--�5 <br /> � <br /> iJJ <br /> b p p <br /> � j� � G� p y � f- � ii � �_: h . <br /> J % �^� p r. � G . ; ' CJ li� C P� <br /> O C .� ... . Y: _ � fJ L 1 P_ <br /> J :C� .: .r � � .� �'J 'A � i Y,' . <br /> Sewer Appl�cation� �nd P�r-��it'; K .- �, � I <br /> � �r �� r �� . _� ' ' <br /> ,:. 's: Z:� L..� � a� mc`� � � si >�'-'. `�'� Z'.. �' ��� <br /> � �� 297aG DATE <br /> Service Address —/1 G r% �'� '/ �� ' �%�= , Utfliry Account No. <br /> Billing Address '��-%i �i� '.J� �/ ,%, �L_ <br /> Clty, State,T `�`.�� , /� <br /> P �--� ��% Permit Fee $ i'%�� <br /> Owner `��Z�-�f - ��`f/J-I �-'�'� Connectlon Charge <br /> Connection by Trunk $ �-?�C• �� <br /> �["f' <br /> , Address Lateral $ �-' �• ��� <br /> � <br /> Total Connection Cherge a 7l� (I <br /> P�O�e Utility Development Fee <br /> Legal Description: Water $ � f� G�J <br /> Lot Sewer $ y 7�•�Z <br /> � B�k Total Development Fee $ �J�Q•�� <br /> Plat <br /> Unplatted Description: Sewer Bond Dfstrict '—�'-- <br /> Abutting Lot Lfne <br /> N, S, E,W fl. <br /> Type of Permit �-91�'��,L("��(jJl'!'��%�')t i APProved By <br /> Remarks Issued By �f'" <br /> i <br /> Customer Signature <br /> IMPORTANTI <br /> CALL 1-600-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> CALL 259-8810 FOR INSPECTION Insper.tfon ey <br /> Date Inspected f <br /> SEE SKETCH ATTACHED <br /> INSPECTION � � 9 7 G ' <br />