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i <br /> � � � <br /> p � x <br /> C, H <br /> Y H V� <br /> � � <br /> H � H f.------ �_"—Y=_". .. .. .. ,.._"�'��-x'G7f+'.-d-:,� �.�.. . . ., ..," -- _,- --'.----$Ti�:i.��',,-5-�--^--�. <br /> o� � ,o� CHART NO. <br /> yy � <br /> x <br /> � y � _ �O <br /> 7d O - � <br /> _ Q <br /> � � g . S <br /> �. � I - .� j�iy� , <br /> H • _ - ` _ -' � . <br /> C" y� � - C <br /> i ..; � •� r 'r� <br /> N y � ���' -� n �` �� /��� . <br /> g �' H ' Sewer Application and Permit '- . � <br /> � d� .. <br /> , , - - , ,_ <br /> �� � ` � :. :, ` - <br /> yo � �� � 2390 ! DATE �9/a/9z � <br /> � <br /> � 5502 �arkview Ln <br /> IService Address Utiliry Account No. <br /> Billing Address <br /> ���.�1��-'' 237EEL1t ST <br /> City, State,Zip ���r�'`� EPER'r.7`T 98203Permit Fee $ 70.00 <br /> Owner �'�`�'�K S�LECT fl0>�:S Connection Charge <br /> ConnecHon by S•,n� � L K cn v, Trunk $ <br /> Address _ Lateral $ ' <br /> 0.00 ' <br /> — Tolal Conneclion Charge $ <br /> � 1 Phone — Utility Development Fee <br /> ��' Legai Description: Water $ 179.00 __ <br /> ' ' Lot 18 Sewer $ <br /> ��� Biock Total Development Fee $ 179.00 <br /> f ' Plat Awnnhrnnk iliv p7 .. <br /> ULID 02 <br /> ��� Unplatted Description: Sewer Bond District <br /> '� Abutling Lot Line <br /> �I N'S' E'W ft. <br /> � Type of Permit �7nx connection Approved By <br /> �' GII <br /> Remarks Issued By <br /> ' �., <br /> � r', . • ; , _L, _. -� <br /> �1 Customer Signature' -�- <br /> � , ; t�v.'�L . <br /> ' IMPORTANT! <br /> CALL 1-800-424-5555 48-HOURS <br /> ; PRIOR TO DIGGING � <br /> 1 Inspection By (l���'�""^ <br /> CALL 259-8810 FOR INSPECTION <br /> � , Date Inspected 3�'- �3 <br /> SEE SKETCH ATTACHED i <br /> INSPECTION : � p�fl � <br />