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CHART N0. <br /> everett <br /> e � � <br /> � � <br /> ct�y or e��ren � 8 � � �3 8 , <br /> ; � Q o yir. I <br /> +� �w X -i .w '� <br /> M <br /> Sewer Application and Perm�� � � � `� � � �_ , <br /> � � � � � � � � <br /> 26297 � � � � <br /> NO. DATE ayquat S, 19e2 __ _ <br /> Service Address _ ���7 Iooz� s� av •a3 Utility Account No. <br /> Billing Address p.�. _ Permit Fee �n en <br /> City, State, 2ip- x...+.fc, r� oezea Connection Charge�s► <br /> Owner (Mortgagor) v■r.. c_ c��.1i Total Fee_ �e_rn <br /> Billing Name_. n... <br /> Connection By <br /> Address Signed <br /> customer <br /> • Phone <br /> DESCRIPTION: Sewer District n.,..a TT= � <br /> Lot ��; Block _ I <br /> , Plat r�� t�U�� Monthly Sewer Service i <br /> Unplatted Description Monthly Sewer Constr. <br /> Type Permit: � Trunk <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> � <br /> Approved By <br /> ciry opinee. I <br /> IMPORTANTI I <br /> Issued By_ u...+...« r r.�l�..w <br /> CALL tA00d24-6655 48-HOURS i <br /> PRIOR TO DIOGING � <br /> CALI 269-8811 FOR INSPECTION i <br /> Inspection By i <br /> Date Inspected � <br /> SEE SKETCH ATTACHED Np ZGZ57 I <br /> I(: Nf CilUi 1 <br />