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ACity <br />erett <br />Sewer Application and Kermit <br />NO. 26155 DATE—_Npril 70 1907 <br />Service Address 1P06 7nt"l<Utility Account <br />Billing Address ---- <br />City, State, Zip - <br />Owner (Mortgagor)—x*ju:-s rAdt4 - <br />Billing Name s--- ---- <br />Connection <br />Address ----- — <br />Phone4 ±3g25 -- -- <br />DESCRIPTION: <br />Lot <br />Block <br />Plat m1by of _ <br />Unplatted Description_ <br />CHART NO. <br />5-64'r >n LI/N'CT1"- //-/b-07 <br />Permit Fee 30.00 <br />Connection Charge(s) 270.00 <br />_ Totdl Fee �V.VV <br />Spacial utility flee Ord. 1171-65 <br />water 179.00 <br />cower 471.00 <br />650.00 <br />Signed <br />Customs <br />Typo Permit: New Connection _ <br />Remarks: <br />IMPORTANTI <br />CALL 1-800-424 555548-HOURS <br />PRIOR TO DIGGING <br />CALL 259.8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Sewer District__ bond 11 <br />Monthly Sewer <br />Monthly Sewer Constr. <br />Lateral_ .:cr-v Mli ON et <br />I,IILI,k 11409.011 <br />Abutting Lot Line <br />N S, E, W ft• <br />04/i3/07 mi).-pe Icm#4952 till <br />Approved By <br />hlKlUlWw <br />Issued By <br />e�LLL <br />B9 <br />1111;1I S2H.:A1 <br />L' 9NII S1.Ci0 <br />Inspection By <br />1-- <br />( <br />WAIE <br />Date Inspectad <br />bt4FR. NO $320155 <br />tw 11 i:.m.�x1 <br />INSPECTION 1171-0 +' <br />tlYlilTllA11t <br />