4670 Traverse Pt SERVICE
Ro.d PER T '_ kt3.:
., yi(IN DATE:
N of units: t•r ; >
-
'Owner: r:
Address:
Address' C.,. 3 :T. 2.�. 'e.6. €". I fff ,: -t
plumber:
W1 Teter No.:
Size: Y Pe�uitM�ce post
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Iralsv the if
A . AINrc. mss pc
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Total:
By Dote iii:
Date of Imp.: // / �'''d �, ,.
of tAGAN SEWER SERVICE PERMIT
mos Pilot Knob .Road PERMIT NO.:
legon, .MN 35122 DATE r
Zoning. i No. of
Units:
Owner:
Address:
Site Address: r , r t - T 1 r
Plumber
1 agree to empty with the City of Easton C
nsction Charge:,. ✓� ^ �' , ,
Account Deposits 1
Permit Fee:
Surcharge-
ay ti
/ 75 0 Date Paid: