Lakeside Park Application to connect to sewer�ner.4� 11-_ 1 �n IQ q� Date_?—N 6G%'
Mailing Locatio___
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Let. .--- Block Trcrct............ ._ _^._......
P. No. —If —1$401-- l A. No ,._ _/ 'o4v,,— :z::
Residential ❑ _ ., I t -, , j M 1at*-L r " u _ � 3 -1
Qommercial p Type4 �i—w-mW{\p' (o{ s.u. ��rJ%ati11s.1.Z..��_�S`t<>....
Front Footag/e�� pp d�s+PerJm-iitt Fee ......
Cantroctor.-.-QLL4I8.__S Inspectiois,/ ..._..
Inspection Approved
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Sinks PT Disposals ❑
PERMIT YGg AFTER
Toilets,El
SOUTH TAHOE PUBLIC UTILITY DISTRICT APPLICATION TO CONNECT O SEWER