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i"��'S�^'� , . , . .r . .. .. . . � . <br /> t; <br /> � - CHART NO. - <br /> �� <br /> �- <br /> r� <br /> = ro PostiNc -L _� � <br /> � <br /> ��°�� � a � � � � � � � � <br /> � L•1 Ci Q \ <br /> � iJ d�. � o � o � I� Iti <br /> �, . ,. � N. w � F, � <br /> Sewer Applic���n an�_���r�� � � <br /> � � � � � � � � � � � � x � � � <br /> � : ;^. 2 95 �9 � DATE �-zs-9� <br /> Service Address 5521 Parkviev Lane Utility Account No. <br /> Blllinp Address 14410 Hel Rad Rd l200 <br /> Clty, Stete,Zip Bellevue Wa 98007 petmit Fee $ 70.00 <br /> �� Colony Czaft Connection Charge <br /> ConnecNon by 1.� V1� Trunk S <br /> Address Lateral <br /> a <br /> Total Connection Charge S "�' <br /> Phone Utility Development Fee • <br /> �����bn: Water S 224.00 <br /> �,p� S8 Hancbraok Div 2 SewBr a '� <br /> B� Total DevelopmeM Fee a ZZ4.00 <br /> Plat <br /> � Unplatted Description: Sewer Bond DlsMct <br /> Abuttfng Lot Line <br /> — N,S, E,W n, <br /> Typg of Permft paM connectton Approved By <br /> Remarks Issued By rtH <br /> Customer Signature <br /> IMPORTANTt <br /> CALL 1-800-4245555 48-HOURS <br /> PRIOR TO DIGGING � <br /> CALL 259-8810 FOR INSPECTION �nspectfon By `"' �r��iu� <br /> l <br /> Date Inspected 3'��—`,'t' <br /> ;'� SEE SKETCH ATTACHED <br /> ; , <br /> INSPECTION . ,:; 2 9 5 c 9 <br /> : � <br />