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A <br />everelt <br />� <br />c��y ot e�e�n <br />i <br />CHAR? NO. -- -- <br />�rS''''r 'io Pe S'tt ►� <br />� �,. , . ey <br />� �� <br />t- �' �.� ; <br />� <br />� <br />Sewer Application and Permit �; ., � , � <br />� � <br />No. 27185 <br />.ai � <br />� � � � <br />DATE _ "'•• 1e �909 <br />Service AAdress_�1�72' ""' " 3� <br />Billing Address_1929-$'""•w � <br />City, State, 2ip_ aa�z�iL r� 9o�m . <br />Cwner (Mortg�ror) xich �y��^ - <br />Billing Name — <br />Connection By ����=P�°e -- <br />Ad�+re;s *-�^�a <br />Phone ��'+-�^^� - <br />DFSCRIPTION: <br />Lot Block <br />Plat <br />Unplatted Description <br />Typa Permit: <br />Remarks: <br />IMPOHTANTI <br />CALI 1�80G�424�5555 48�HOURS <br />PRIOR TO DIGGING <br />CALL 259�8911 FOR INSPECTIOiJ <br />SEESKETCH ATTACHED <br />Utility Account No. <br />Permit Fee_.— <br />Connection Chargel <br />Total Fee _ <br />Signed c��sm�� <br />Sewer District_._ <br />Monthly Sewer Service. <br />Monthly Sewer Constr. <br />Laleral_ <br />Abutting Lot Line <br />N, 5, E, W <br />iAPplOVe(18y c�snnn e �rtrn�i. <br />C�iv Enpineer <br />I <br />Issued By �Qe—'' ' "^'�"'� <br />i <br />�' <br />Inspection By—���J�� , <br />D�ue Inspected_ ��% — <br />No. 27185 <br />