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._^__. -^.t+vss��r.a•®•'""'.v1i:':irsh^m:atzas:.�ava»Mn.; <br />'r <br />}x� <br />8 8ES <br />e8� <br />cr m N <br />Sewer Application and -Permit <br />IRS <br />S9.14 9 DATE 10-12-93 <br />Service Address _ <br />5910 'ND AVE S <br />Billing Address <br />— <br />City, State, Zip <br />EVF.RM WA 98208 <br />Owner EARL FARMER <br />_ <br />Connection by <br />GOTT CONSTRUCTI01; <br />Address <br />it,na urpurpanw <br />ARLINGTON NA 98223 <br />Ph <br />653-3131 <br />one <br />Legal Description: <br />Lot <br />Block <br />Plat <br />Unplaaed Description: <br />Type of Permit <br />Remarks <br />NEW CONNECTION <br />IMPORTANTI <br />CALL 1-300-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Utility Account No. <br />CHART NO. <br />TO POSTING�a <br />Permit Fee $ _ 70.00 <br />Connection Charge <br />Trunk $ <br />Lateral $ <br />Total Connection Charge $ <br />Utility Development Fee <br />Water $ <br />Sewer $ <br />Total Development Fee $ <br />400.00 <br />400.00 <br />Sewer Bond District �— <br />Abutting Lot Line <br />N. S. E. W ii• <br />Approved By <br />Issued By ' x1ry <br />Customer Signature Vy_ <br />Inspection By�"`� , <br />Date Inspected /y 5- <br />29449 <br />INSPECTION <br />