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CHART N0. <br /> everetl <br /> i , . <br /> � _ �, � , -. � _ � <br /> , �. <br /> City of Everen <br /> Sewer Application and Permit <br /> N0. 2�)4�5 DATE _ <br /> Service Address Utility Account No. <br /> Billing Address 111 88 Ev�rett Mall Na� Permit Fee 30.00 <br /> City,State, 2ip eoeratt, NA 9820� Connection Charge�s)_330.00 <br /> Owner (Mortgagor) RC Con�truction Total Fee 30.00 <br /> Ear• SP�cial Otiltly Tae ORd. 1171-OS <br /> Billing Name wat�r 179.00 <br /> •awer 471;00 <br /> Connection By Base F;0.00 <br /> Address 6�sa Signed <br /> customer <br /> Phone 3S]-5770 <br /> I DESCRIPTION: Sewer District Bond ZII -- <br /> Lot 17 Block <br /> Plat <br /> L�r�on Park Monthly Sewer Service <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk 3�0.00 <br /> Type Permit: <br /> Lateral <br /> Remerks: <br /> Abutting Lot Line <br /> N S E 1�� °'b/H8 3�5','(YI ix)�wYf if4t ' <br /> idHr.ilfi�ll <br /> I�IJi� 79 ',?.1� <br /> I'II1; 5:�O.lal <br /> lflLL A.� ' �L <br /> — Approved By AL ,�,i�j`$�_ <br /> y pmeer' <br /> U �d�r:ll s :.`+�J <br /> IMPORTANTI � <br /> Issued BY_��JI,���9�.�q�— <br /> CAIL 1�800�424-555548�HOURS <br /> PRIOR TO DIGGING "�n��M�-""^' <br /> 6hJ i,-dL(41 <br />. CALL 2 i9�8811 FOR INSPECTICN ; i' ,�:'�, � <br /> Inspection By �� '� <br /> i � � i .� <br /> Date Inspected � '�' __ � ���•�u� <br /> i i . �v��.o., <br /> SEE SKETCH ATTACHED N�. 26�6� <br /> li!�Pf C i ICl(d <br />'' <br />