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- -- _- , - , -- . , _�....�. , . - <br /> �_ . --- --- - --,.. CHAPT NO. ---_----- <br /> I <br /> � � <br /> >�� i TO POSTING. �-3�-v 3 <br /> C" yN � . � '.�' . <br /> �M <br /> �M� �� Sewer Application and Permit <br /> �n ri � =, �: '. <br /> �x� I 293� 3 DATE �/3o%y3 <br /> �v <br /> p�g � Service Addre�s <br /> 5929 Seahuret Ave Utility Account No. <br /> �y �:I Billing Address )� 00 — <br /> C� <br /> �� _ ... ouor�� Permit Fee $ <br /> �t~n H � City,State,Zip <br /> �y i Red Raven Connection Charge <br /> � � Owner <br /> Trunk $ <br /> �w ' Connection by <br /> �ateral $ <br /> � Address <br /> �I Total Connection Charge $ <br /> , <br /> '�, I Utility Development Fee <br /> Phone ---- <br /> �I �� I Water $ ---�— <br /> l_egal Description: � <br /> Sewer $ <br /> LOI <br /> Total Dovelopmont Fee $ <br /> Block <br /> I ` I <br /> i Plat <br /> � Sewer Bond Dislrict i <br /> II �1� Unplatted Descriptiorr. I <br /> � Abutting Lot Line i <br /> ft. <br /> I N,S, E,W ! <br /> I _ <br /> `� I Altcretlon/Hepair ApprovedBy.—. I <br /> I Typo of Permit Rb <br /> issued By ,�- I <br /> i Remarks _—� �—�-y 1�'' '• t i <br /> �� i Customer SlgnaWre � <br /> 1 i �� <br /> � i�)� 11�,� i_'���� �� ��r��^-��� ��/Y'-' � <br /> � � I IMPORTANTI , _ • <br /> �� �; .: �, �;rr � � ��� ��� , <br /> � , <br /> �. �i�,i,?r1 .� ��.� . , <br /> �I CALL 1-800-424-5555 48-HOURS � <br /> � PRIOR TO DIGGING C�I6',� � <br /> Inspection By <br /> CALL 259-8810 FOR INSPECTION Date Inspected � C� � � <br /> I <br /> I . <br /> I SEE SKETCH ATTACHED ? �3�$ <br /> INSPECTION ' �-� <br /> �i <br /> � .___. .. - - -- <br />