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everett <br />e <br />c�� of <br />Sewer Application and Permit <br />CHART NO. 6 �'Zq -S <br />�o��. a - � � <br />,� <br />N0. 23686 DATE ��'°�t 7, 1980 � <br />��21at Stz��t Utility Account No. <br />Service Address nr� ,, <br />Billing Address <br />City, State, Zip <br />Owner (Mortgagor) <br />Billing Name <br />Connection By Citp o! E�as�tt <br />DESCRIPTION: <br />Lot <br />Plat <br />Unplatted Descr <br />Block <br />Tvna Permit: S�vair <br />Permit Fee none <br />Connection Chargels)_ <br />none <br />Total Fee <br />Don xill�r <br />Signed <br />cu:mmer <br />Sewer D <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />SEE SKETCH ATTACHED <br />Ti <br />butting Lot Line <br />N, S, E, W, <br />g, Warren <br />pproved By <br />Gry Engineer <br />E. Boad <br />�sued <br />�spection By_-� <br />�ate Inspected� �,�_��1 ��-� -- <br />rvo. 23686 <br />INSPECTION _ ,_ <br />. ._ . <br />