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CHAF�T NO. — <br /> evtren /�� r/ t <br /> :�� >� t�� L,;y .s-��-��I <br /> � � � <br /> �;. <br /> r <br /> City of E�`eren � �? S �? P= 4 B �3 � a 8 =,^ <br /> '� � � P � � <br /> M '� � � ~ M ` � Y M �M LJ <br /> Sewer Applic�otion and P"�r�nit ' � � <br /> .. �. <br /> - _ _ .� - ,� <br /> � � � � � s � � _ � � � � �a <br /> 26947 � ; � � � � mW � . . � � �� <br /> N0. DATE <br /> $ervice Address ��n ��,�_�_�„� _ Utility Accou�t No. <br /> Billing Address Permit Fee_�t:,: <br /> City,SWte, Zip -�Tp� �p�a Connection Charge�s) . <br /> pwner (Mortgagor) w-.. �+.--, Total Fee � <br /> Billing Name Otilit� Drwlq�wn! l� OrA. 1171-aS <br /> rt�t 179.00 <br /> Connection By__� � �c �71.00 <br /> � ` 650.00 <br /> Address J _ Signed�;1 l . <br /> customer <br /> Phone ���� �— <br /> DESCRIPTION: Sewer District <br /> Lot Block Monthly Sewer Service <br /> Plat <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk <br /> Typs Permit: ' <br /> Lateral_ix_ <br /> Remarks: <br /> — Abutting lot Line <br /> N� S, E, yy ft. <br /> Approved By <br /> 0 M <br /> IMPORTANTI <br /> Issued By <br /> CALL 1�600-024•555548-HOURS <br /> PRIOR TO DIGGING <br /> CALL 259�H811 FOR INSPECTION _ -� � � <br /> Inspection By�.1 - <br /> Datelnspected�/�� <br /> SEE SKETCH ATTACHED Na. 26947 <br /> INSPGCTIGU <br />