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C�1ART NO. __ <br /> Ieveren <br /> e :�:; <br /> � <br /> ci� or e�e►sn t g 8 8 g � 9 <br /> � � s � s r; :: � <br /> I tA w� M } M � <br /> � Sewer Application and Perrn�t � � � � � � � � <br /> � � � � � <br /> 26828 �=, : "` � � '� �` � � � <br /> N0. DATE �Pu►s�r e; 198e <br /> Service Address 1{271QQtb at tw �169 Utility Account No. <br /> Billing Address a� Permit Fee 10.00 <br /> City, State, Zip Ewr�tl. M11 96201 Connection Chargcls�_ <br /> Owner (Mortgagor) �d�a�d fbrl�r T�tal Fee 10_00 <br /> Billing Name � I <br /> Connection By <br /> Address Signed .' � y � / � <br /> cwwme, <br /> Phone I <br /> DESCRIPTION: Sewer District wO^� III <br /> Lot 169 Block <br /> Plat �+►�v htatu Ilobil� Ila� Park A9onthly Sewer Service <br /> Unpletted Description Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: ,W, ����r�� <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W .ft. <br /> � <br /> — --- i <br /> APProved By t*.►�ee a_ exeit__ � <br /> Cny Enqmeer <br /> IMPORTANTI <br /> Issued By W�q�i E �*� —_.__ <br /> CALL 1$00�424-666548�HOURS <br /> PRIOR TO DIGGING <br /> CALL 269�8811 FOH INSPECTION <br /> Inspection 8y —_ <br /> Datelnspected � <br /> SEE SKETCH ATTACHED N0. �v��8 I <br /> INGPf:CIICN <br />