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CHANGE VVATER-AND SEWER AUTHO . IT. <br /> Date: <br /> -Acct.N46. <br /> .. <br /> ' <br /> \.• 1•'rl- •.,y i J r-r• r.i i !.� •.r.� <br /> . 'ter•^ i "+ r <br /> f owner <br /> ! °' r• ,, , f <br /> 1. <br /> a�rcet i:•rr _ ! __ <br /> Ism wrap block <br /> f f lot <br /> ' subdivision r <br /> lot <br /> WATEd <br /> t <br /> Acreage Fee <br /> i Density F-ee S <br /> �t Front Footage Chg. S <br /> __•,gyp• t <br /> Meter & Tap Clig. $ j <br /> Total Water Chg, S j r'��•, <br /> S EWE fl: <br /> Acreage Fee $ 5f,!-,. %• <br /> Density Fee <br /> ff 'C. 4• <br /> 1 Front Footage Chg. <br /> Tap Chg. <br /> Total Sewer Clig, <br /> TOTAL PAY�+iENT :_:.' $_a:,91 , <br /> General Cont. <br /> . '. : Plurabing conl.'�iJ�t'J��P.luny 13�t�G •Ca: .. <br /> 'fieceived by: <br />