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i <br />` CHART NO. <br />( eyerett <br /> � - <br /> City of Everen I <br /> Sewer Ap�.�lication and Perr�it � <br /> ia t,Narr �, 19a s I <br /> No. 25032 DATE I <br /> Z <br /> 0 <br /> p76 :.mith � Utility Account No. i <br /> Service Address " <br /> 2.5 0 �'.' <br /> 3327 Rnckar Permit Fec <br /> Billing Address — --- <br /> eartt, Na. 992�1 ComectionChargefs) �� <br /> City,State, Zip Z.5 0 <br /> Total Fee I N m <br /> Owner (Mortgagor) � KQD�n j <br /> co <br /> � m o <br /> I � <br /> � Billing Name � ���n �, o m <br /> � � <br /> Connectinn BY � � ,!' ,% - / T � <br /> �'k 'm <br /> Signed� �,.�� ;(( � '� 1 �% .- �-�:. .. <br /> / II .� � <br /> Addf¢55 Cusmmcr I <br /> Irr. ._. <br /> , Phone a°y051 � -i v+ <br /> I < <br /> ! Sewer District �' <br /> � � n <br /> DESCRIPTION: ', <br /> Lot�-- B�ock Monthly Sewer Service � _{"' <br /> Plat <br /> 5. SO' of �hnt ptn of �t�e i� of nik 25 "' n <br /> gp9alxX��rtl[X Monthly Sewer Constr. i <br /> srt <br /> Unplatted Description �� <br /> J.S. Si�y r A�r+ Tra�is Trunk I � N <br /> Type Pe �nP-off i � m <br /> Lateral i A <br /> I � <br /> Remarks: Abutting Lot Line = <br /> N, S, E, W <br /> ft. z <br /> -a <br /> I x <br /> If'OIA S G C�O w .'� N <br /> Nn Call �! n [ "�.c.-. '. Z <br /> T. R. Theal I o <br /> p w o w^ n <br /> —_ l��—�-4 Approved BY c;iv e�y��c�� �� m <br /> E. Hond <br /> ���_� 7-i9-Pf Issued By � <br /> i <br /> � <br /> i <br /> Inspection 8y - <br /> Datelnspected I <br /> SEE SKETCH ATTACHED N0. ZSO�Z j <br /> � <br /> IN:PECTIOId �� <br /> r <br />