|
, � ' -
<br /> � SAC DETERMINATION - 2010
<br /> (In-House Use Only)
<br /> � c (�� ! � �
<br /> Date Completed: Date Determination Expires: 12/31/���
<br /> Address: ?� � Z ��- `( S t d-�. ��
<br /> PID: ���"- � I � - Z. � `� Iy - L"C ��
<br /> ���'��� �� ���� ,z t'���� �s �,�+�. = �� � �",�' W
<br /> �' � h"�..�� �T .8�.a'"�^..`��io-S �� " ?�p€F � . E'S A "s y �h
<br /> � �`�""" �+��^�"'� ��� i ' ��� �w '-+� - _ ?�� f
<br /> t�u� ��
<br /> �-��`�'��-,n-r`�'� - j- '��+ ��,- ?'7 a �'-�� � �" � �'"x . � � . �-�:
<br /> '�su _ �� � b,�t�� �'� �- '� 7 `�.� _ ` "y
<br /> - _ ea -. ..s.,.b� �.� ,vi�. =..�-e�c.,,.Y�,.��r...�,_.,� . r"'`..-.- �2' .
<br /> ��C` � � �,�,�' � ;��� � ��� —
<br /> _ _ � � �° y,
<br /> �� � � ` �,�a� ,% r.^T ����
<br /> � �
<br /> �� _��; �- � � � �� �� - �j�s y
<br /> a_. a - �9�;
<br /> �('`�� - � :
<br /> �����..- .:� ��� t, .���r ..��,�� ; ., �� � /c�
<br /> _--- -- 6�-!b�ti
<br /> �
<br /> , �a .., � ���:., � �.�� ����� ��a��� � � ��ZC✓�i
<br /> �
<br /> r ,�� � � �� �� �'� � � � ��� �{
<br /> � � � � � � � °�� � ��� t�
<br /> � �
<br /> �
<br /> � ; �� �� ��� �' ` �� � ������ ��`��� _
<br /> �' sa ���,�z.;�� ,��. '�'r .�«�+l^'`,���ri ;{ �'� ,'`��n�
<br /> �' �,i� i.i�i
<br /> �< < u�; '.Y'- �� x�„�bB" ��' ��-����
<br /> .��'`�; ,- � '° a , '�'`�s�� ��<
<br /> �
<br /> '�, � �� t , �w��������`� �
<br /> � ���`� � ` �� � ' F ^ v* _�,����-�.
<br /> ����� � ��� � � �� � � ����� ��
<br /> 0
<br /> �,��.�����-� � .x 3� -� -s � �`�*i�..�3 °'���' r '°"�,� ��.s��,
<br /> � � t <
<br /> ?�3'_ ,�... � . .,,. ._ � ,. � . � ;eia`te�.az., �>.
<br /> �
<br /> �'JAC C?UE': �i �°E.'4 NO
<br /> � �
<br /> If Demo Permit Being Issued—Get Copy of Utility Bill to Attach to Demo Permit: ❑ Attached
<br /> � f�
<br /> Comments to Key on Permifi ��>�:�'�-> ��� �^� �` i �1���' ��'� � � ' �C��l� � �'��r���` L-�E��
<br /> Notes: C� �k c-� l fi C�/I��!��
<br /> Completed By: � Date Completed: � � �1 l (;�
<br /> �i ��-
<br /> Nore:
<br /> • This form is for residential properties only that are already in a sewer area
<br /> • Any commercial, industrial, religious or schools—determinations are made by Met Council in a letter
<br /> format(Lyle is contact personJ
<br /> • Not for properties currently on septic, wantinp to hook-up to sewer for first time. These properties may
<br /> not qualify, or may have to pay large sewer assessments in addition to SAC
<br /> (Scott is the contact person)
<br />
|