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� <br />SIDE SEWER PERMIT <br />'� SILVER LAKE WATER DISTRICT <br />�10 - 1YhM Bt. i.E <br />ENntl, Wnhhqlon M70! <br />»fa6q <br />The undersigned Owner hereby makes <br />for properry described as follows: <br />Legol Deuription: <br />� � 7 y /��c>r����a,. <br />•`—'� ; I v�Fi' C-( � r t i <br />Address: <br />� <br />. . . . ,....___ .__ _ __. y.�,�.,'l,l <br />;' ,�." <br />ao3 ; �5 <br />(03�/ <br />applicoNon for a sewer connection to sewer mains of the bistrict; <br />sf�,� <br />t� ",,1 I t X � <br />.,�:l..�.......././..a�.`.'.... �..7.......5..� .................. <br />..., ..F.....0 ..i ..:................................................................ <br />The Owner hercby oprees ro be ba+nd M�a�� <br />rules and repulotions, raw In force or os re- <br />inofter omended, of ths Sewer Dlctrid. � <br />; ! % <br />................Y � ' ��.r........ <br />..�.. .......�....- ::.:...F........�•••.�..,.. <br />�r'� Siphoturo <br />......-�--�------ -- <br />..� .::............................................................._........ <br />. owne: s Mol�fr+p /lddrcss <br />O D �!� (f ' n ' <br />.......1..�:...IG . '............_...... <br />� COSt .......... ....J`�..�....................................................... I: , , • � ,.......... <br />...................... <br />,.. � ............................................................. _... <br />... :.. ,. BIIIinp Addreu <br />Contractor ................. . . � . .�/ .,�.;.................Lleense Nq.........................`.......��..._............ <br />efte�nner�shall�Nehrcsp nsi6la o�r��o�l operot� � Int no�ce o'nd repo� Dth�fd� �r,• Q�� D�, '4 <br />ry <br />, f 1-��� .............. 2 � . ` <br />permit issued b .................................... � , : <br />y :................................. <br />