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�- ---- -- <br /> _ - - <br /> CHART NO. --- <br /> � � �I - _ TO POSTING �'_ <br /> y _ ..�����►�r, __-�- <br /> t'y� I . � .�' . <br /> ��� I Sewer Appl�cation and P�rmit <br /> ��� � _ . <br /> N <br /> �x� I ?.93 ,�7 DATE __ �/30/93 , <br /> o�d <br /> n Service Address _ 5915 Seal�uret Ave Ulility Account No. <br /> Q`�� I 5�e <br /> y y� �i Biliing Address 70.00 <br /> E" M � City,State,Zip <br /> svereu ti1A 982�� Permit Fee S <br /> g�y i ��ef iwri■ xucl�erford Connection Charge <br /> � <br /> � Connection by <br /> Trunk $ <br /> `�� ' Lateral �------ <br /> Address <br /> -�- <br /> ; <br /> Total Connection Charge � <br /> � Phone Uliliry Development Fee <br /> Water S ' <br /> C� �� Legal Descriptiorr. t,00.0. 0 _ <br /> ',I �, -- Sewer $ <br /> i Lot <br /> Block <br /> Tatal Developmeni Fee $ 400.00 <br /> I �� Plat <br /> � Unplatted Description: Sewer Bond Disirict <br /> �il 1 1� Abutting Lot Line <br /> � tt. <br /> N�3, E�W ; <br /> `��i Type ot Permit rer+ Connection Approved By <br /> �! gb� <br /> Remarks Issued By I' - <br /> Customer c ' ' ^"' ' � �J�_� <br /> ..�b..,..... � ,_, I �. ,,�/ <br /> J ���I'f ZpJt/�� `�at n dJ`.�C Wn �7 i <br /> � � IMPORTANT! ' <br /> -�(� ��%'� �CII,LJIU/?�1_:{c 7-L�t�: I <br /> I CALL 1-800-424-5555 48-HOURS � � <br /> I PRIOR TO DIGGING ������'p�� _ <br /> Inspection By _� ��, <br /> Ii CALL 259-8810 FOR IN3PECTION Date Inspected ��—�— <br /> I <br /> I <br /> SEE SKETCH ATTACHEQ � y 9 3 5 7 <br /> 'I INSPECTION � - <br /> � <br />