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� _ CHART NO. —__ <br />� <br />�, TO POSTING �'S�3 <br />� ' �F��:n�wt' s- ��.z ' <br />� -r_�- r� c c�r� <br />' ii :i�� �r�.. �_o�. <br />� „- « -R � N h ^' <br />� � f O '� .. <br />Sewer Application and Pe_r;mi,� � �, <br />i'. O[� L: - al C i�l O �i �a �� <br />. n [5 '� ' -" -. � :- � - �Y �'� E;: <br />:�.i..:���., �� :.. � -.G� ..:_� <br />�j� _ <br />� 2' 3 4 S DATE � e••z�-92 <br />Service Address 1407 Hadronn �vc <br />Bill�ngAddress l405 Nndto,in Ave <br />. City, State, Zip tvarecc xA 98203 <br />Owner V�zry Hansen <br />! Conneclion by a+�+or <br />Address <br />�� Phone Z52-5403 <br />��, Legal Description: <br />� Lot � of Shorc Flnt 25-78 <br />Block <br />� Plal _. <br />' Unplaned Descriptlon: _ <br />Type o� Permit NF.FI CONNECTIOH <br />Remarks <br />IMPORTANTI <br />CALL 1-800-424-5555 48•HOURS <br />PRIOR TO DIGGING <br />CALL 259•8810 FOR INSPECTION <br />� , . , <br />Utiliry pccount No. <br />PermitFee ;. 10.00 <br />Connection Chaiy.. <br />Trunk $ 270.G0 <br />Lateral $ �50.00 <br />Total Connection Charge $ 720.no <br />Utility Development Fee <br />Water g '-=4.00 <br />Sewer $ 599.00 <br />TotalDovelopmeniFee $ D17.o0 <br />Sewer Bond Distnct i i <br />Abutling Lot Line <br />N, S, E, W <br />Approved By <br />Issued By � <br />CustomerSignaWre � <br />Inspeclion By � " ""� � <br />Da1e Inspected � - `a �� J 3 <br />SEE SKETCH ATTACHED <br />INSPE.^.TION � � �� 9 � � <br />n. <br />