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everetl <br />e <br />City of Ermett <br />Sewer Application and <br />No. 254 <br />ioo�,�s � <br />Service dress ��^ <br />Billi Address 1321 t.�. <br />City, <br />M. 9�70�i <br />0 <br />� � <br />CHART <br />�of> � S'�r st� <br />g�,��-��. s ,.� _�6 <br />. „_ <br />('��� <br />�_ Utility Account No. <br />1N� �lt� 1 permit Fee �•� <br />y Connection Chergels) 3�0.00 <br />Owner (Mortpegor) �O°b= w1K � � F ���� <br />Billing <br />Connection <br />Phone �W-M� — <br />DESCRIPTION: <br />Lot ls—.— 81oc',— <br />Plat /ir-�: <br />UnplatteJ Description <br />Typa Permit: <br />Remarks: <br />Mw Ooametim <br />IMPORTANTI <br />CALL 18004Y4-6656 AB�HOURS <br />PRIOR TO DIGGING <br />CALL 269�6811 FOR INSPECTION <br />uFE SKETCH ATTACHED <br />To.n ee — <br />Ordia�nw 11171-K <br />lhtu 17l.00 <br />Nwr �71.00 <br />iS0.00 <br />, � <br />S,g�Ki _ � . � <br />cmtomer <br />Sewer Distnct_ _ <br />Monthly Sewer Service_ <br />Monthly Sewer Constr. <br />Trunk <br />Lateral <br />Abutting Lot Line <br />N, S, E, `N_ <br />sa� 1!1 <br />f.SO <br />I Approved By i_ a. �rl <br />U�v Fnpinen <br />IIssued By a• �_ <br />)�0.00 <br />Inspection By � -�-- <br />Date Inspected_� � <br />No. 25421 <br />ir�,rrcrio� <br />