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�';�' < ,--..�, <br /> �Y^ ; ' y��."�4,`�,�;{�;,�r+:� . 7 . <br /> 1 <br /> CHART N0. <br /> � . <br /> r: <br /> a <br /> �o P�sTiNc 3-�� -9� <br /> � gZtSg � �{ � � � .�s � <br /> t� ; � <br /> � _ C C r� <br /> � �,1 R 'i; O G �iM1 O .-+ �in -. C' <br /> � W � N M I� <br /> ��t , <br /> � + � N ��� <br /> Sewer Applic�t��n an�-.Pe m� r �= <br /> c � ;_, <br /> �', � 5,�^ "-�� `�"go�`5 � `.Sr p- ��'+ s - �• <br /> O d � �.,. � iJ iu � 1 G � ?' h �I •-+ �- <br /> � <br /> ," 29497 ~ DATE 11/3/91 <br /> 5633 lst Dr W ' " . <br /> Service Address Utility Account No. _ <br /> 237 Eln St <br /> Bllling Address 70.00 <br /> Lrrerect W.� 9H2O3 permit Fee $ <br /> City,State,Zip <br /> �e� Salecc Aomes Connection Charge <br /> Connection by � C F _ Trunk $ '— <br /> Address Lateral S <br /> Totel Connection Charge E -a <br /> Phone Utility Development Fee <br /> Legel Description: Water $ 17S 00 <br /> �t 39 Sewer $ <br /> Bbdc <br /> Total Development Fee $ 179 00 <br /> Plat `�---�---,. .,... �. _ <br /> Unplatted Description: <br /> Sewer Bond District 111.ID f 1 <br /> Abutting Lot Linc <br /> NSEW ft. <br /> Type o(Permit Nev connecCion Approved By <br /> gb <br /> Remarks Issued By <br /> Customer Signature <br /> IMPORTANT! <br /> CAIL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING 1- <br /> Inspection By � v�/��"� <br /> CALL 259-8810 FQR INSPECTION Date Inspected �' � —�y <br /> SEE SKETCH ATTACHED � 9 4 9� <br /> INSPECTION <br />