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I � � t CHART NO. --- <br /> 7 <br /> " . TO POSTING �-� -5 <br /> I _ _ <br /> I , <br /> I�� Sewer Applic�tion and Perrr�it <br /> � <br /> � 29A5$ DATE �!�/ia/43 <br /> Service Address Zb:5 Lombar� Avn Utiliry Account No. ---- - ' <br /> 1022a Nli Pointa Dr Gt:: -'•UO <br /> Billing Address <br /> Eirkland WA �5033 ��'��� <br /> City, State, Zip Permit Fee $ <br /> Owner :icDonalde Corpnrutian Connection Charoe � <br /> Connection by Trunk $ '� <br /> i <br /> Address Lateral $ — <br /> Total Connection Chr�rge $ -�t <br /> I� Phone Utility Development Fee <br /> Water $ 110.00 <br /> Legal Description: I <br /> 6-15 &22-2G Sewer $ 448.00 <br /> I Lot �; <br /> G1E4.00 <br /> Block ��K Total Development Fee $ � <br /> I Plat Plat of I:vcratt <br /> IUnplatted Description: Sewer Bond District <br /> I, � <br /> i Abutting Lot Line � <br /> N, S, E,W ft' I <br /> i ,,ev coiu�ectiou � roved B <br /> � Type of Permit � PP y <br /> 293G.00 cresiced to Uti1 Uev Fre 8b � <br /> I Remarks Issued By <br /> Customer Signature � <br /> I � IMPORTANT! <br /> I, CALL 1-800-424-5555 48-HOURS I <br /> ! PRIOR TO DIGGING ` � �' I <br /> Inspection 8 'C'� �`-`�� I <br /> i CALL 259-8810 FOR INSPECTION y <br /> � Date Inspected _ � '" �� �y �� <br /> I' SEE SKETCH ATTACHED <br /> INSPECTION 2 Q 4 5� <br /> ! <br /> i ' <br /> � __ <br /> ' _ _ <br />