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, <br />, . , .. _,...,. . ;�?t----- , ., .. —„-.T^.— <br />'� <br />� <br />u <br />. ,...-��—;.....,:.�...::rr_',_`,—�.-"'_`.^ <br />CHART NO. _ 'i <br />e� �OSTING -�s �' <br />� " �. � . <br />�, . . . � �.r .: D O <br />'s p <br />Sewer Applic�ation and Permit � P`L .. <br />�, � ,y �� �; <br />,_ <br />,. <br />11/23/93'� -,` _. <br />? 9 5 � ? �ATE <br />5210 i 4Cli Ava <br />Service Address <br />Billing Address <br />8216 HeaninA Dr <br />City, State, Zip Stanwood GA 98292 <br />Owner John Feet <br />Connection by <br />Address <br />Phone <br />Legal Description: <br />Lot Lot 6 S.Y. 45089 <br />Block <br />Plat <br />Unplaried Description: — — <br />Type of Permit Naw connection <br />Remarks <br />IMPORTANTI <br />Utility Account No. <br />Permit Fee $ <br />Connection Charge <br />Trunk $ <br />Lateral � <br />Total Connection Charge $ <br />Utility Development Fee <br />70.00 <br />� <br />Water $ 2b1 00 <br />Sewer $ G88.00 <br />949.00 <br />Total Development Fee $ <br />Sewer Bond Dislrict <br />Abutting Lot Line <br />N, S, E, W — <br />Approved By — <br />Issued By <br />Customer Signature <br />&1� <br />n. <br />CALL 1-800-424-5555 48-HOURS / <br />PRIOR TO DIGGING .� <br />_ Inspection By -% <br />t' ���%� <br />�, �• CALL $�9r8810 EOR INSPECTION '-� 1 � , � , y��--- <br />___ -- - Date Inspected � <br />SEE SKETCH ATTACHED 2 g 5 3 Z <br />INSPECTION - , <br />