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, ---- - - - -_ -- - -._ -- - <br /> _ - - _ __ _ _---- ---- -------;--- _ <br /> ICHART NO. --- <br /> �, � �ntTIP�G .3_ z� - 3 <br /> 'I ' 'r5 C. � -; ;_; i �` i_; �';. �_; u u ;i� <br /> �Crl� , "� r' v � ... . .. , i =i Gi '.. Mj :n � ^, i i CI <br /> � M <br /> �.�.ti � l 1 .. . .. � .: <br /> '4 C] � • Cl �t d <br /> �ayy Sewer Application �ncf� Permi�#G �, ^ � � _ � � � � �; � � ;_, <br /> H �� . . Ci � - .. r) [n T_ O L- i <br /> H H � `I'' . . _, .� c> ` w � & _� c 2 �3 .��i,i ' <br /> �C O I ' <br /> o x o ' � � �� ''; DATE a/z7/°2 <br /> �1 H"� - <br /> fp H <br /> � 0 3 16 Glonwood Ave Utilit Account No. <br /> y� Service Address 1' <br /> 10217 19th Ave SE <br /> � �� i Billing Address <br /> ��� Evarect WA 98208 PermitFee $ 70.00 , <br /> City,State,Zip <br /> t" y� � <br /> x �W�ef Himiieyu uomau Connection Charge <br /> g �H � Connection by Trunk $ <br /> �� �c� Address Lateral $ � <br /> y vi Total Cunnection Charge $ � <br /> H O Cn - <br /> Phone Utiiity Development Fee ; <br /> �I <br /> � Legal Description: Water 5 179 00 <br /> � Sewer g 471.00 <br /> , Lot <br /> Bluck Total Development Fee $ 650 00 <br /> �`� j <br /> �� P�at <br /> � Unplatted Description: Sewer Bond District <br /> ��,�� Abutting Lot Line ! <br /> N, S� E,�N n' i <br /> """� Type ot Permit t7ev connection Approved By <br /> GD � <br /> o� <br /> Remarks Issued By i <br /> �� Customer Signature i <br /> . <br /> �v-. ,�� <br /> IMPORTANTI I <br /> �� <br /> CALL 1-800-424-5555 48-HOURS �- � <br /> � PRIOR TO DIGGING �^� / , <br /> "�""' ' Inspection ey �'�t�` <br /> CALL 259-8810 FOR INSPECTION 3U- 5 L � <br /> Date Inspected �n ' <br /> SEE SKETCH ATTACHED ?°8 4 7 <br /> INSPECTION • <br /> i <br />