Laserfiche WebLink
RPM <br /> CHART NO. <br /> Tn PMT1NG L <br /> 8 866 <br /> � ypQ� <br /> T A <br /> Sewer Application 7nh.2— <br /> �� <br /> d erm <br /> - .M , 1 <br /> 29743 DATE <br /> Service Address 7 Iz10 7 ��� Utillty,'ccounlNo. <br /> Blliing Address <br /> City, State, Zip ) /V (� Permit Fee $ <br /> Owner Y l — Connection Charge <br /> Connection by �a� 5 Trunk $ <br /> Address Lateral $ <br /> Total Connection Charge $ <br /> Phone Utility Development Fee Q <br /> Legal Description: Watar $ 7 - <br /> Lot <br /> Sewer $ H 7/_-�� <br /> Block — <br /> Total Development Fee $ <br /> Plat <br /> Unplatted Description: Sewer Bond District <br /> Abutting Lot Line <br /> N,S, E.W ft. <br /> Type of Permit �)QlI J �G11AJ0/ /in Approved By <br /> Remarks Issued By— <br /> Customer Signature <br /> IMPORTANTI <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING // <br /> Inspection By— <br /> CALL 259.8810 FOR INSPECTION Date Inspected <br /> SEE SKETCH ATTACHED 29743 <br /> INSPECTION <br />