4672 Traverse Pt 144010‘11R 1
!1 t T tfic � , ' L
IM!'' 35122, DATE
No. of Units:
,. '` 4[ >72 Travers 'oi
' . ,t I:4 }33: "Xect t 4t '1
?�. GCY E Pan
►: .. 305.
' ow", valitillirelii4j10 Stn co 06 - Id meter
D oto of Insp..: / - (9 - -t-
for itiesAti --SEWER- SERVICE PE*MIT
'R7 5 Met Kweh Rosd PERMIT NO.: Y
n, 5M22 DATE 11 /E' /!.70
Zoning: P Z I T `No. of Units: l unit trip e
Owner: nr `111rrp wn Fan
/�lddrass:
Site Address• . 4677 Traverse Point T4 1 "'l deer 3 iff 4th
number: renz Pvan
10/2/80 21166 100.00 pd
I agave to amply whh tap rety ei Eye• Connection Charge: 42 5.0 0 rd
Account Deposit:
Permit Fee: 1(_ 0t) pd
Surcharge: - 5n PI'
BY ) Misc. Charges:
Dote : of �. 0 Total:
hug " ^ �'C? - Date Paid: