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■ <br /> _ CHART NO. <br /> eve�rn � <br /> e , � <br /> City of Ererett <br /> Sewer Application and Permit <br /> No. 25354 DATE — _ <br /> � <br /> Service Address����,��9��� Utility Account No. -- <br /> Billing Address t J Permit Fee_ .���— <br /> City,State, Zip �� ! �, "� Connection Chargels) <br /> Owner (Mortgagor► � � � ' .— Total Fee �� � <br /> Billinp Name ' � <br /> Connection By '— � <br /> i <br /> � <br /> Address Signed <br /> ,/ l CU:nmer <br /> Phone 3 ��7– Z`'tZ�i <br /> DESCRIPTIO � � Sewer District — <br /> Lot_�1— Block ��Q�es Mc.nthly Sewer Service __ <br /> Plat — <br /> Unpletted Description _ _Monthly Sewer Consr,r. <br /> Trunk <br /> Typa Permit: , , , <br /> Lareral � <br /> -- i <br /> Remarks: <br /> I <br /> Abutting Lot Line <br /> N, S, E, W_ ft. <br /> � - Approved By_ <br /> crtv En9men <br /> IMPORTANTI <br /> Issued 8y _�_ _.'..-� <br /> CALL 1EOOd24-655548-HOURS <br /> PRIOR TO DIGGING <br /> CALL 269A817 FOR INSPECTION .� � � <br /> Inspection By1s.�-�'"'`�— L,�—�`�'`" — <br /> r�ate �nsPected__� ' 3 &G �—/ _ <br /> SEE SKETCH ATTACH!�D No. 2:i354 <br /> IfJSP[CiIOfJ <br />