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<br /> <br />tv't=-T - fOSf toM LT.O Date: <br />~\IO I'~ ~~Gf~ (~N -!1 W~ <br />~o/rl(0l~ 191Lt1 <br />5 \'2-- 7/(}o c;? c; -7 <br />r;!L-- UO ,~ 7'7 <br /> <br />lame: <br /> <br />\dd ress: <br /> <br />'hone: <br /> <br />=AX: <br /> <br />::-mail <br /> <br />\late: Please include check for recording fee payable to "Hays County Clerk" for $14 + $21page for legal description. <br /> <br />~-'1f~~Y":"-~"~,~-:; t:{ii~;x~r:!:i~i:;~;~"0'" ': ~"y>: _:" .~~~ c : ,",.-~ ~~'t: 0 . ", ~~ :~., ~~~ ,~' v'0~ ~ 'f~: ~"'Y~t: ,~'l:" :: ~~' ::;'~.; ~~~'~"'''''~'",0' yo, "; ~~~ W'",,""~ =_.~ '9 ~ '0= ,,~~~ryz~1t:,:r>;: " ~ -.~><<~. -'"''''f~-q M <br />"~d' '5""" 1:[" " rlA'J" "t0f~~~ff& #1:;V*- ,"; " ;c.,~if r~~' 4)"' ""%t<>>~'i J l f -& I::.I i'4 _$iJ wi L if 1 t; < ~. i1 j. , ,^ , <br />~~ >.t_.....,.~......:<,~;.:J.r.:;:~~r-;v.............:~~~........... ",:-!;"'"<,;;:: ;,~...::;;*JL -'"~ ".i;;~~:; ~~~ ......t~~./.w~ .-.<,.,., -./::~r'" ~ <-"....-;- ...;;.)!t[: f/~ :'.i~ : T >'~ 01 ~.... ~ ~ ~.....~~~~.a;~;!n~~~ ...: "-:'.r""'':/~~P'''~~~''''''''~i4~'''''~f''''''''''~''':''.#''''~;'''-'-':......~... ~ '"...../: ~ ~ y -. w..:-<- i..;...... ~-:;.-"h "I'>I..,~~ ~-wo.~:.:\ci;~~~jg~~:-~ ~:. <br /> <br />Location: <br /> <br />\bOO <br /> <br />fCk;1"" ~lw ~ <br /> <br />~tu (\A~S' <br /> <br />~ <br />t' <br /> <br />7i{1~~ <br /> <br />Development Name & Developer (if applicable) <br /> <br />r~ (UJA--P V t Vt.-~ S <br />(00 Ptt::l0f \tV , I~ Do tv At.-O ( !1l <br /> <br />Total Acreage: <br /> <br />4.0 Ik- <br /> <br />Plat Date: <br /> <br />Tax 10 Number: R <br /> <br />,08 1 <br /> <br />\~ '0 Pj <br /> <br />Proposed Use: ~Residential 0 Commercial 0 Industrial 0 Other ~1l=- <br /> <br />Water Service Area (CCN): <br /> <br />Service Requested: ~stewater* ~ater <br /> <br />Type of Request: rI Connection to existing main <br />4-'~ SU,t:. t ~ <br /> <br />*Note: City wastewater service is available only for City water service customers. <br /> <br />o Extend existing main to subject property <br /> <br />Estimated Utility Demand: <br /> <br />~/ Please attach calculations for average and peak flow conditions for each service requested, <br /> <br />d' Please attach a map and a "metes and bounds" legal description (from deed or survey) of the property fcij..,hich <br />service is requested. -- ,::t>- <br />-r:J <br />o If the property is not contiguous to the existing city limits, please attach the required requests for annexat~ along the <br />extension. (Not required for connection to existing main fronting the property to be served.) <br /> <br />r (~CJ feltT1 ( S 601'Jl i 6 (1' lc\ ~ \lv~ I fl1 <br /> <br />~- i (l.-t l TS , <br /> <br />Page 1 of 2: of <br />EXHIBIT B <br /> <br />See Owner's Acknowledgement and Consent to Annexation on the next page. <br />Form last updated: 10/26/05 <br />