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a <br />I �n.. i,. S ..�� <br />� ��/���I�� <br />� <br />, . . ': `:�. , . <br />Y' <br />� <br />'-3 ; k; ;� 1� ; . ;,, r ,. <br />� : � �5�� <br />� ' � t�,, _; �•. <br />� : . Ll - h� lJ <br />� �.� ' � .� '� d S <br />�'� r: C •n <br />Sewer Applicatio� ��d PQ�jt �.� i <br />?3 ��'� � "v ;�'��+��� �_ ` <br />r= -w.0 G, ,� �. <br />� 291U7. DATE 3/3/93 <br />Service Address <br />aioz ct.na <br />Bllling Address 18800 lhry 99 Ste 1! <br />Clly, State, Zip Lvnmood NA 98076 _ <br />i�L�ID� Til6�gii1 <br />��� e <br />Connection by — <br />Address <br />Phone <br />Lepal Description: <br />�� 17 6 18 <br />Block y <br />Plet _ Terrace Addn <br />Uppletted Description: <br />Type of Permit Naw connection <br />Remarks <br />IMPORTANTI <br />CALL 1-800-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Utiliry Account No. <br />CHART NO. <br />S�\N� ���'q3 <br />�O �0 <br />Permit Fee $ 70.00 <br />Connection Charge <br />Trunk E <br />Lateral S <br />Total Connection Charge $ 0.00 <br />Utility Devetopmont Fee <br />Water � '.79.00 <br />471.00 <br />Sewer a <br />Total Development Fee $ , 650.00 <br />Sewer Bond District <br />Aburiirg Lot Une <br />N, S, E, W K• <br />Approved By <br />GB+ <br />Issued By <br />� � rr <br />CustomerSignature ��`���4�`� '� � �r �' <br />Inspectfon By { �'�P��'�"" <br />Date Inspected �/�� <br />INSPECTION <br />.' 291 a2 <br />