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.. CHART NO. — — <br /> '� a TO P�STING I�-2-2-�f� <br /> � <br /> � P$ 8� ai .��.�F-. r �? ��= <br /> c�i .iy�. �c. -� o o .. <br /> _ . �: e� .. .. ... �� w c� " <br /> Sewer Qpplication anc� �Perm_��- � � �� <br /> ��, = �� ,_ �, =� 7p�;: � � :- _ <br /> �~ pO �iJW.� L:._ C� TC _ 1_� <br /> �9 2.',8 DATE Jl 5/�19/93�. .� � _ :_ � .,�; <br /> Service Address 3823 Aroccr Avc Utili�y Accouni No. <br /> Billing Address 3013 Panovlw 81vd <br /> Cily,Slate,Zip �erett HA 9820J Permit Fee � _ 7n.Co . <br /> Owner T4eodora Herchavkn Connection Charge <br /> ConnecLon by Tmnk $ <br /> Address - Lateral ; <br /> -�- <br /> ; _______—_.—. Total Connection Charge $_ <br /> ��, Phoac� __....._—__.— UtilityDevelopmentFee <br /> ��I Legal Descripiion: Water $ Y.4.00 <br /> ���. !.ot 5�___ Sewer g 569.00 <br /> Etlock Total Development Fee $ 813.o0 <br /> � Plat _ 6��verl�axk <br /> Unplatted Descriptlon: Sewer Bond Dlstrict — <br /> . Abuning Lot Line <br /> — -- N,S,E,W _ tl. <br /> �, Type ot Permi� tiaw connectlon _ Appmved By — <br /> � Remarks ____ Issued By g6 <br /> . j <br /> CustomerSignaWre�/�� -�� a�f% ,� �;�, n <br /> 7T—_, <br /> IMPORTANTI <br /> CALL1•800-424-5555 48-F10UR5 <br /> PRIGR TO DIGGING � / <br /> CALL 259-8810 FOR INSPECTION Inspecqon ey 1/ J�*'bC���'•� <br /> Date Inspected 9��J —`�' <br /> SEE SKETCH ATTACHED <br /> INSPECTION " ��2� � <br />