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, � , <br /> 'y 'j• % . I :M � M • Y � y <br /> ' t , <br /> CHART NO. <br /> ., - <br /> TO P���lING - <br /> Sewer Appli�ation and Permit <br /> . ��� ,ti � � DATE zo-2o-9s <br /> Service llddress '93� xulton Se Utility Account No. <br /> Billing Address <br /> City, State,Zip <br /> Permit Foe $ 10.00 <br /> Owner �agle xardwnre Connection Charge <br /> Connectfonby �icrra Constructian Trunk $ <br /> Address 1671b NB 79tU Lateral $ <br /> Redaond WA 98052 Tatal Connectlon Charge $ <br /> Phone 985-3797 Uliliry Development Fee <br /> Legal Description: Water $ <br /> Lot — Sewer $ � <br /> Block Total Development Fee $ <br /> Plat <br /> Unplatted Description: Sewer Bond District <br /> Abutting Lot Lfne <br /> N,S, E,W tt' <br /> Type of Permit ��P off Approved By <br /> Remarks <br /> Issued By .ni _�---- <br /> Customer Signature <br /> IMPORTANT! �N s�o�" '" <br /> �o <br /> CALL 1-800-424-5555 48-FiOURS � ���%3 <br /> PRIOR TO DIGGING <br /> Inspection By <br /> CALL 259-8810 FOR INSPECTION Date Inspected <br /> SEE SKETCH ATTACHED �5 y� .� <br /> INSPECTION - <br />