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P - 74965
y.�, , ::.-� ., � : <;s,��s.c�>}�u�- � . �. �;s.��' :;s;�^-:.:+��g;:'°�.� �> � -, %�( �'. ��� !'� CIT��� FRID�LEY � , k ' WATER AND SEWER CONN�CTION PERMIT ,; APPLICATION �- (r+om. own.► o. rlwnb..) --�j � r. / � :G�� `'�1 � � �l;E.> . 1(� , Date: f�� � ,t9� �7� [ � LE�AiL DESCRIPTION ' `�M ' o�w� 1 NAGT VR ADDITI0`1!1 � �'+C� f �%�''�•�tiLi �il ��i �!Z PE�IIIT: --' SEWER: �''"�' WATER: "� METER: FEE: J��-� FEE: �'•.�a} t`� DEPOBIT: ��y O-DJIPTER: �_ S11lICHAlICsE: ' •S t.-% SUFiCHA�RGE: ' � Z% _�� > > ', . e: TOTAL: � � � TOTAL:� � TOTAL: �,,.� '�1�/ ' :� (a GRAND.SOTAL: 7 � 5./1.C. CHARGE ON EXISTIW6 STRUCTURE: EXIST{AIG STRUCTURE: --=' NEW STRUCTURE: � � 81i11DING PERMIT No.: °?� /'S"� SEWER/WAf��A P� MIT NO. 9�'' � �i �;,�; //; �.;. .�f �-, = � 8lf�C1�l►L ASSESSMENTS• ��� ✓ � ; BY' � __... ` ` ` � "T'����' �,,, ��� " . � � �' . �y �