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CHART N0. <br /> Ieveretl <br /> � �: <br /> � <br /> City of Everen � g g g g g g <br /> j O �(i � 1� <br /> J �� � � ♦ .r <br /> Sewer Application and ���t � � � �� <br /> � �: � �, � <br /> � � � � � � � W � <br /> N0. 26307 DATE ��t 1� �1987 � p � � <br /> Service Address 1127 — 100th Bt 8M I]0 Utility Account No. <br /> Billing Address 8a� Permit Fee 10.U0 <br /> City,State, Zip ��xt, 101 98201 _ Connection Chargels) <br /> Owner (MortgaQor) �� N• ��� Total Fee 10.00 <br /> Billing Name e� <br /> Connection By <br /> Address Signed <br /> cuslomer <br /> Phone _ _ <br /> , r DESCRIPTION: Sewer District �nd ==I <br /> Lot +o Block <br /> Piat Monthly Sewer Service � <br /> Park <br /> • Unplatted Oescription Monthly Sewer Constr. <br /> — Trunk <br /> Typa Permit: <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W__ _ ft. <br /> Approved By 1►LiARD R. TlQJIf. <br /> Clry EnOinen <br /> IMPORTANTI <br /> ISSUEd BY M�nI��• ��� <br /> CALL 1�800d24-65u548•HOURS <br /> PRIOR TO DIGGING I <br /> CALL 269�6811 FUR INSPECTION <br /> Inspection By <br /> �Datelnspected ._ <br /> SEE SKETCH ATTACHED NO. �63OT <br /> li,, l„ . ili,�� <br /> I <br />