HomeMy WebLinkAboutRECEIPT 2 - 04-00241 - 47 Mill Race Rd - Sewer Line127XVda
ADDRE;
APPLICATION FOR REXBURG CITY SERVICE
PLUMBER Sc \ t
PROPERTY OWNER—
WATER SERVICE: Type Size
Water Connect......
S
Water Meter .......
S
Meter Boz .........
S
Ring 8 Lid.........
S
Curb Slop .........
$
Setter .............
$
Sewer Connect .....
$
TOTAL ............
5
In City Out of City
Storm Drains — $
APPROVED BY