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•�,'r---.f:.�;r'r=yr"�r,G�g •� ... , � �. ."'?�p � . . � .,;•�:x+, ' ,`i,. . �"�.�+is;('T' :,�,., :"k�.��S.. �,���.. . e . 7 ,.. s;R"t .. <br /> _ �. . fJc+-rT: . .�m.-- <br /> � � '��.. . � ,-�. .�em.. .1.�� . ... , <br /> CHART NO. <br /> �� TO POSTING 7-zs- q� <br /> TT ,; <br /> ' _ r_� � r- �,, n �. <br /> !`� u'i •.� 8 r� f�� i-i <br /> � ; .. ,* `� '_=� _ `,% <br /> ,: . " _ � <br /> �� :n -a r� r" � <br /> Sewer Applica�io�:, �n�; �'e�r�it . � <br /> .. r_� c o °,; =, - r� W =, � � wr'�� <br /> Yj p in U ', " :;t r_. _z r=� 3� �= 41 w � <br /> O � G iG ._ �' W . <br /> ��j s^. c: �- �. ,. :� �: i1 ��. ._ '_ iit CJ i <br /> :._ 29662 r�DATE f 2iz9/94� � <br /> 2b19 Lombard Utilit AccountNo. <br /> Service Address 1' <br /> Billing Address <br /> 10220 NE Pointe Dr 'J3G0 � <br /> &irk.land 98033 PermitFee $ 10.00 ' <br /> Ciry, State,Zip i <br /> � Owner ctcnonalde Conr�ection Charge <br /> Connection by Trunk $ <br /> Address Lateral $ <br /> Total Connectior Charge $ <br /> Phone Utility Development Fee <br />� Legal Description: Water $ <br /> Lot Sewer $ '. <br /> Block Total Davelopment Fee $ I <br /> Plat <br /> Unplatted Description: Sewer Bond District <br /> Abutting Lut Line <br /> N� S� E�W ft. <br /> Type of Permit _ �ap'Off qpproved By — <br /> Remarks Issued By <br /> Customer Signature <br /> IMPORTANT! <br /> CALL 1-500-424-5555 48-HOURS <br /> PRIOR TO DIGGING / <br /> Inspection By be�ixAn <br /> CALL 259-881a FOR INSPECTION ���,y <br /> Date Inspected <br /> SEE SKETCH ATTACHED , � ', � a � <br /> INSPECTION - <br />