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_. . . - - --- - - - - - - - — — <br /> �-- ----�-.---�-- ��. ,, _,; } �-- - _ - <br /> . . . . ., . . . r . . l` � . .., , . , '��, �i.-.�-.-,-fi.�in � ..<`."'��.1r�",�'�;?�i <br /> - CHART NO. <br /> , <br /> :_, TQ P(�STi��; '� .- -9� <br /> ,, - - - <br /> ,� , : <br /> � �� � __ �� <br /> Sewer Application4}and Permit <br /> :_ ^ :, ; �u I <br /> �. � :; ,,; �_ <br /> '� 2954Q DATE _ 12/7/ss I <br /> 2805 Lomburd <br /> Service Address Utility Account No. i <br /> BillingAddress p0 Box G?9 <br /> Ciry, State, Zip �eXecc WA 9820G _ permit Fee $ -�•00 I <br /> Owner Volunceeza of Aaorica Connection Charge I <br /> Connection by Trunk $ i <br /> Address Lateral $ <br /> Total Connection Charge $ _ <br /> Phone Utility Deveiopment Fee I <br /> Legal Description: Water $ <br /> Lot _ Sewer $ <br /> i' <br /> i <br /> Btock Totai Development Fee $ � <br /> Plat <br /> Unplatted Description: _ Sewer Bond District <br /> r <br /> _ „_ . Abutting Lot Line <br /> —. N, S� E,W __ ft. <br /> Type of Permit Cap-of� Approved By � <br /> gb <br /> Rer�arks _ Issued By— I <br /> � <br /> Customer Signature <br /> IMPORTAN'�! -�,,,,,� <br /> • ��,1 I���� <br /> CA!L1-800-424-5555 48-HOUiiS � 1 �� ,�PSuPs�� <br /> PRIOR TO DIGGING f{�o.1"S�'eU/ �,� <br /> CALL 259-8810 FOR INSPECTION Inspection By � � , <br /> Date Inspected — � <br /> I � <br /> SEE SKETCH ATTACHED I <br /> I :1 ' A I <br /> INSPECTION � 5 �+ ' I <br /> I I <br /> � , <br /> � <br /> �a <br /> � <br />