Laserfiche WebLink
�•^?,'� ��r.T1�� : i.7 F�� T <br />.. . . -. . . � � r . .... . ,.. . . . . <br />�� <br />� . <br />— ..-r... .: . �, '" . . . <br />CNART NO. <br />,� <br />:�, a �q � 3 <br />- � @OSTING�� <br />��� oa��1 <.]C <; � ���.� <br />:C L'J f.i �. � L'1 L''S G �ry Q-. <br />� � ' rj � [� M . <br />�'? b p^. �a., � u- , <br />�� w M �M ., .-v e;; •-� O. <br />V? � , i- .c M <br />• .tr A � � <br />Sewer �4pplir,�tion and� �,�.ermi� _ � < <, � �� . <br />- G.i f� O fJ Ci •• <br />V'1 f_i C:1 L: T f 1 1":- :^ O p �� � f, <br />ry t,:QiilL� O�A _. (-i i-Q 43�"W <br />- ��I J Ll J ii L'� �_ p 6 O lsl .-� S <br />{.i ee r.] G_ '. .: � G'� � Y�.. 3F -.t e'C VA � C.1 <br />, 2 9 i?_ 6 DATE 3124/93 <br />Service Address 32 56th Yl SG <br />Billing Address 14410 se1 RPa Ra u2oo <br />City, State, Zip �� � �T" �� <br />Owner Se�Bny sfe€� <br />Connection by <br />Address <br />Phone <br />Legal Description: <br />Lot �7 <br />Block — <br />P�at Hanahror'- IT — <br />Unplatted Descriptlon: <br />Type of Permit N�+ connaction <br />Remarks <br />IMPORTANT! <br />CALL 1-800-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Utiliry Account No. <br />Permit Fee $ <br />Connectfon Charge <br />Trunk <br />Lateral <br />Total Connection Charge <br />Utility Development Fee <br />Water <br />Sewer <br />Total Development Fee <br />Sewer Bond District <br />$ <br />$ <br />$ <br />70.00 <br />00 <br />$ _ 1�7` .00 — <br />$ <br />$ 179.00 <br />ULID <br />Abutting Lot Line <br />N,S,E,W h' <br />Approved By <br />GB <br />Issued By ,.�.--.-- <br />�% <br />Customer Signature __ <br />�, �mc% <br />Inspection By <br />Datelnspected ����y3 <br />INSPECTION <br />'� �9i2� <br />