Laserfiche WebLink
. . , t , . . . <br /> �� <br /> . - CHART NO. <br /> � TO POSTING 3-����-,'. . <br /> � <br /> � <br /> � �io3vr' r�S� C� � oo <� <br /> � r� r� <br /> u' � pmO �7C w. G G ,-i0 <br /> ,1 Q� i � S'" . <br /> O `,ij �s �a �N T+ ~ aC. R�: <br /> f:t nt � aa yi � <br /> Se�r�r Applicati�n�nd����r��i� . �-; � <br /> .ti � �4"�' V L] U� � Z rJ f— J � C- L�J <br /> [. � <br /> .? � W li �:iA2.' LJ .r.l .�A� � � � � r�+ f�l <br /> I . 29631 DATE ' ��"��� <br /> ����r� y� ' - � /�-��`�J� Utility Account No. — <br /> � � ',� ��, � <br /> I sa�i�o naare� /��'G��' � ; �1'��di�.�r�!�.�;�L <br /> Clty,State,Zip ' , '������n r,"� , 7��.�� Permit Fee $ �C�• �l� <br /> p�� �-%,1, -//r�„�,,;�lrY11��� ConnectionCharge <br /> Cannection by Trunk $ <br /> Address Lateral $ <br /> Total Connection Charge $ `� <br /> p� e Utility Development Fee <br /> Legal Descriptbn: Water $ �����' <br /> �� % Sewer $�!, �l <br /> IBlodc Total Development Fee $ s � �' � � - <br /> � ria� �; � �„�J� Kr� �r%„ ;^�� <br /> Unplatted Descripdon: Sawer Bond District <br /> Abutting Lot Line <br /> N,S, E,W n' <br /> Type of PertnR ' �i'i� i ('�>;��fr'fi��✓ Approved By ' <br /> Remarks Issued By � <br /> Customer Signature � <br /> IMPORTANTI <br /> CALL 1-800-4245555 48-HOURS <br /> PRIOR TO DIGGING <br /> Inspection B — <br /> CALL 259-8810 FOR INSPECTION �j���9,� <br /> Date Inspected <br /> SEE SKETCH ATTACHED ' : ,�, .,•2 9 6 � � <br /> iNSPecYior: � <br /> I <br /> i --- — --- — <br />