Laserfiche WebLink
I <br />F everefl <br />�e <br />� ct�. ot e�e�t�tt <br />( <br />( Engineering & Ccmmunity Sarvices <br />CHART NO.J'� "��' " z�—'S <br />,` `—r.� _ <br />-I ... i� <br />. ._ <br />Sewer i+�piicctian and Permit <br />N0. -� _� f F� ni 4ATE '%�.-: .r' 7-�• <br />. , 1/0 3 //�2� ��ti�i��,a <br />Service Address l��' � �'-t-��� Utility Acr,ount No <br />Billing Address '�a �?� = Permit Fee <br />CitY, State, Zip �✓� ;� %: '; V✓�a5 /-/_ `>1":.0 / <br />Owner(Mortgagor)�?a�t�+�= L l�INS�1�.:•��- <br />Billing Name � •k"�� � ' <br />Connection By :- � � r !' r��/,Y �'4 ~� <br />Phone _ <br />DESCRIPTION: <br />Lot Block__ <br />Plat � � ,'� -;� ` /f � ,. .. �� .��� <br />Unplatted Description -��� - 3 `i - i <br />Type Permit: <br />Connection C <br />Total <br />'� � � '; - <br />Signed �-, - - :,y, .- z�. <br />Cusmmer <br />u <br />SEESRETCH ATTACH[D <br />, 'il <br />Sewer District _ <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Trunk <br />Lateral_ <br />Abutting Lot Line <br />N, S, E, W_ <br />, <br />/i: <br />Approved By , = ''"'?� �:�� <br />City Engineer !� <br />�,�� '. r <br />✓ <br />Issued By �, ���_�%rt*n�' <br />Inspection By. � -�>� <br />Date Inspected �� -/ j' - 'Y 7 <br />NO. � _ . - <br />:�,,�.�� �� � <br />'�a�:'x . . �.� . ��� �.rYG <br />n <br />