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P - 75022
..rt��ei� �:� ._ � 0'y�q:`,��'�'"�; ,� r ;� � � w�'�;: CITY OF FRI�LEY WATER AND SEWER CONNECTION PERMIT APPLICATION . �c� � � Lc� ti.J� (Homs Owr�r or i�'/JS(� DESCRIPTION ' � � � � ii Date: �" � 1 MIT: � `� �--- SENIER: WATER: � METER: FEE: FEE: OEPO6�T: O-DAPTER: STATE STATE SURCHARGE:�._ SURCHARGE:_�� TOTAL:�S TOTAL: /� GRAND TOTAL: f /� / �� CHARGE ON EXISTING STRUCTURE: Uj� TOTAL: STING STRUCTURE: NEW STRUCTURE: LDING PERMIT No.:_T J SEWER/W1�►TER P IT NO.: � CUL ASSESSMENTS: Si • � � gy; �l �