Laserfiche WebLink
a< <br />k <br />0 <br />x �. <br />Sewer Application and, Permit <br />n DATE a 33-9 <br />vn7 / <br />Service Address ,� 9G �-AL'-'Z- r Utility Account No. <br />Billing AddressL/�l t" <br />City, State, Zip 1( d `7 -2- 7� Permit Fee $ <br />Owner 7 Connection Charge <br />Connection by Trunk <br />Address <br />Phone <br />Legal Description: <br />Lot <br />Block <br />Plat <br />Unplatted Description: <br />Type of Permit <br />Remarks r <br />IMPORTANTI <br />CALL 1-800-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />CHART NO. <br />TO POSTING JUN 0 3 1996 <br />Lateral <br />Total Connection Charge <br />Utility Development Fee <br />Water <br />Sewer <br />Total Development Fee <br />Sewer Bond District <br />Abutting Lot Line <br />N, S. E, W <br />Approved By <br />Issued By <br />Customer Signature <br />Inspection By _ <br />Date Inspected <br />X" <br />INSPECTION <br />ft. <br />