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„ CHART NO. -- - -- - <br /> � ro <br /> � � � TO P05TING _!-�`�-Q3 <br /> N � <br /> � {y � <br /> ^ON � - P � �i i; , . <br /> u � .. i� l� � y . �. <br /> R <br /> M +1 , <br /> � � Sewer Application and Permit �_ M `' <br /> � � <br /> N <br /> � y � ' �' � � DATE ---��/�. - — <br /> � � H 762� Bnnr.rJc l,r _ <br /> �p Service Address Utility Account No. <br /> � _ 8111ing Address 21611 45th Ava SE <br /> Bothell HA 98021 i��.On <br /> Ciry, Slete,Zip Permit Fee $ _ _ "'';'-`_�• <br /> Owner Hithere Conecruc[lon Inc Connectlon Charge <br /> Connection by Trunk $— 1���•��' <br /> Address —_ Lateral $ 450.Oo <br /> Total Connection Charge $ �`�'�� <br /> Phone Utility Development Fee <br /> rLegal Description: Water $ 179.oG <br /> �� Lot 2 Sewer $ 471.00 <br /> 1 '�� Block TotalDevelopmentFee $ 6'��-�� <br /> ��� SP 14 •90 <br /> Plat <br /> II <br /> �� <br /> Unplatted Descriptlon: Sewer Bond District <br /> I ��� _ Abutling Lot Line <br /> N, S,E,W —_ — h• <br /> Type 01 P9rmit Nec connectiou Approved By <br /> �� -- <br /> cn <br /> Remarks — Issued By_ ._ <br /> ' '-1�' Customer Slgnature � �'/ <br /> � <br /> i <br /> IMFORTANTI <br /> ����� CALL 1-800-424•5555 48-HOURS <br /> PRIOR TO DIGGING .-� � ,; � �� �,' �` <br /> � � �,'; <br /> CALL 259-8810 FOR INSPECTION Inspection ey� � `;�= — <br /> Datelnspec�ed <br /> SEE SKETCH ATTACHED _ <br /> ws���crior� - � <br />