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I everen <br /> ^,HART NO. <br /> � <br /> City of Everen <br /> Se��rer Appli�ation and Permit � <br /> � <br /> N0. `vZ�O DATE _ .n.�y ai �eg� <br /> Service Address 1�Z7 - ioosh st sx ��s Utility Account No. <br /> BillingAddress �� Permit Pee_. _ �n_rx+ <br /> City,State, Zip g..�.�r, a qB2a Connection Chargels) <br /> Owner (Mortgagor) ae.e mrr �ctal Fee _ �n_en <br /> � <br /> Bi�ling Name x.�. <br /> Connection By <br /> Address Signed <br /> cuf�omer I <br /> PF10f18.— 4[O�tfil <br /> DESCRIPTION: Sewer District m...-� rrr <br /> LOt �a BIOck <br /> ' Plat �arar E�lab� Mobil� ase P�rk Monthly Sewer Service_ <br /> Unplatted Description _ _ Monthly Sewer Constr. <br /> Typa Permit: — Trunk <br /> Lateral <br /> Remarks: OB/U3/N7 4�14qH OOpAN6alo tklt <br /> Abutting Lot Line / <br /> N, S, E, W��11037 ft. <br /> DI'i.20 610.U] <br /> S'lhNhJa`i16 <br /> -- 4h�1f6 �A11.00 I <br /> NWU;S:'4u <br /> - Approved By � �• �� <br /> IMPORTANT! �y-L�; 910.U0 <br /> CALL 1AOOd24•6655 4B•HOUpS Issued By__ w4�.l��t � t�� I <br /> PHIOp TO DIQG;NG � <br /> CALL 268�8811 FOR INSPECTION I <br /> _ Inspection By I <br /> -- Date Inspected <br /> SEE SKETC4 ATTACHEU Np, ZGZ�7O <br /> IfJ';PI_C�i�IOfJ <br />