Laserfiche WebLink
� <br /> c _ <br /> CHART NO. � 3� � � I S_ <br /> everet! <br /> OS���� � <br /> e _ = _zs - � � �� <br /> � � <br /> c�ri or e�e�ett �� I, <br /> S�wer �A�plicafion and Permit <br /> , <br /> NO. ZZ7H6 D4TE � i <br /> � Service Address Utility Account No. <br /> .�.. <br /> r Billing Address Permit Fee <br /> i <br /> � City,State, 2ip Connection Chargels) r� i <br /> Owner (Mortgagor) Total Fee ' i <br /> Billing Name j <br /> Connection By_ <br /> i <br /> Si ned � � <br /> Address 9 <br /> Cuslomer <br /> Phone_— — <br /> DESCRIPTION: Sewer District <br /> �, <br /> Lot__ 81ock <br /> Monthly Sewer Service <br /> Plat <br /> Unplatted Description M�nthly Sewer Constr. <br /> Trunk <br /> Type Permit: — <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W_ rt. , <br /> Approved By <br /> Ciry Engmeer <br /> Issued By � �, <br /> I <br /> � r `�� � <br /> Inspection By `"�v/ ��Y""""'"" � <br /> Date Inspected � —`� / — <br /> i SEE SKETCH ATTACHED NO. ZG9PU <br /> II � _ , � . � �t , � <br /> �-r <br />