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<br /> <br />Note: <br /> <br />r;~l/" ~Z~q: < ~Pl1L.i~,_~j~'f~,l!~J1itJ1QI~~llo:l!.;1~,::, <br />'I,ftJGe ~) 0 VI.". .48'&t:IC.- Date: cJ.49V 'I " <br />~,,!t ~U$~Ec..c.. D~. <br />~~n1J, T),. 7t7o'f <br />'if%. ~ZM U,;,7 <br />s,z-- "'-"'6 0' t'i <br />~M4Ut" (! ~tl~tI ~ ,~ · <br /> <br />Please include check for recording fee payable to UHays County Clerk" for $14 + $2/page for legal description. <br /> <br /> <br />Name: <br /> <br />Address: <br /> <br />Phone: <br /> <br />F P\X: <br /> <br />E-mail <br /> <br /> <br />Location: <br /> <br />^' ,",~<7fiJ;fJ1!1JI1;iCgQL~^ ' <br />Jt:.I (..N *' ~ AI tlltrf1 of t:k.() .Nsr" ,,""'. <br /> <br />Development Name & Developer (if applicable) WIN() el4et2e PAtJ:;. j <br />z"o~, N. FM "ZO :S./~(} /IfImIJ n. 7t7; ~ <br />I <br />Total Acreage: 2-/2." S~ k. <br /> <br />f-.I f') 4-4-' <br /> <br />Tax 10 Number: R ID VO'\' I e. J~.1 L I J z.,o~ I (l./~u7/1, ff, '2. ~, <br />/ ~..".,. <br />Proposed Use: ~esidential ~ommercial 0 Industrial 0 Other ,.,."..... <br />Water Service Area (CCN): f\)#'1,1t) rc'lJ <br /> <br /> <br />WUGli We/JO<;. <br /> <br />Plat Date: <br /> <br />Service Requested: ~astewater* ~ater <br /> <br />*Note: City wastewater service is available only for City water service customers. <br /> <br />Type of Request: lrtonnection to existing main 0 Extend existing main to subject property <br /> <br />Estimated Utility Demand: ~; If {, 1r- IV i z,1z. qp* IfIfAl-1~ : tANI : ,,'fJU,/F:: ~ <br />11 P WNiF=:~ ",... <br />rY"" Please attach calculations for average and peak flow conditions for each service requested. I' <br /> <br />fit" Please attach a map and a "metes and bounds" legal description (from deed or survey) of the property for which <br />service is requested. <br /> <br />o If the property is not contiguous to the existing city limits, please attach the required requests for annexation along the <br />extension. (Not required for connection to existing main fronting the property to be served.) <br /> <br />See Owner's Acknowledgement and Consent to Annexation on the next page, <br />Page 1 of 1 of <br />EXHIBIT B <br /> <br />Form last updated: 10/26/05 <br />