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�— � <br />� l*vPrEt! <br />� <br />City of Everatt <br />Se�ver Application cand Permit <br />No. 2�950 pp�Tr Nory�ber 4� 1986 <br />CHART N0. <br />SE.v: 7�, Ctn._�.2:r. //,�id �iG <br />s8'3 GSgeS$ <br />0 <br />4 n8` �r;$c� <br />• N� V� M <br />� � <br />� ��: <br />w!�}� • J <br />Ul M � N I^ � <br />C.� � � � <br />Service Address 2226� - llfith St S8 Utility Account No. <br />Billing Address 71�0 Po�ter Slouah 1� Rd. Permit Fee__�p„p� <br />City, State, 2ip_ Brwho►i�h, 1T 98290 Connection Chargelsl— 330.00 — <br />Owner (Mortgago�i��_�o�t Total Fee �p,pp __ <br />Dilling Name �r. <br />Connection By potl'�;��w�y�� <br />Phone 5���-Tg�tt� <br />DESCRIPTI ON: <br />Lot _ _ Blor.k <br />PIAt <br />Unpla:ted Descr <br />Typa Permit: <br />Remerks <br />IMPOqTANTI <br />CALL 1�800�424�5555 �B�HOURS <br />PRIOR TO DIGGING <br />CALL 269A811 FOR INSPECTION <br />5EE SKETCH ATTACHED <br />SF»cinl Otility 'r�, Ozd. 1171-65s 5�0�.00 <br />Signed _ <br />cutitomer <br />Sewer District��t� <br />Monthly Sewer Servic.e__ <br />Monthly Sewer Constr. <br />Trunk <br />Lateral _ <br />Abutting Lot Line <br />N, S, E, W _ <br />I APProved By �n�ti., <br />c��v �y���r <br />I Issued BY�- �rot-Y llaL��d <br />� <br />Inspxction By�. �� <br />Datelnspected �� � � _ <br />No. 25J5Q <br />li:::l'LCIIG�J <br />