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! <br /> � � � <br /> p �x <br /> Qy N <br /> C �y <br /> y � � — - -� ��:f.qGr:,-- - -wai�X--; >,—,w'k?q'F"'.,..�...._,:.�r��,�=.. � , . . . . . . � - . � . <br /> FC t7 . . . . � � . . <br /> � H;d CHART N0. <br /> y �i . <br /> o �� ; ' ' p0s %v <br /> to <br /> �� g : j r_\��z_93 <br /> �,,, � _ . � ,:. ; ` <br /> � <br /> y~� � 'i � � � c ' <br /> C y � '� . » a �� r"t <br /> H H � � ...: � io � .., <br /> g�y Sewer Application and Permit , 3 � p � �, � � � ; <br /> � ,, � � , � ,. <br /> � . � _ ; <br /> y o rv'i, ^ t3 9 0 it DATE 9/ti/92 . - <br /> Service Address _ 5601 Parkviev Ln Utility Account No. <br /> �.,�necnc�n�]►V'6 237 F.la 5[ <br /> Billing Address <br /> City, State,Zip � ����� Fverett 9A?03 permit Fee $ 70.00 <br /> Owner xxa ?P�+YYe'b�Fk�xh�x Selecc Nnmv. Connection Charge <br /> Connection by S^��` �D' °"c"�. Trunk $ <br /> Address Lateral $ <br /> Tolal Connection Charge $ O.OU <br /> ' 1 Phone Utility Deveiopment Fee <br /> '�' Water g _ 179.00 . <br /> Legal Description: <br /> f 1 Lot 13 Sewer $ <br /> ��� Total Development Fee $ 179.00 <br /> Block <br /> � 1 Plat Uenebroak Div t�2 <br /> 1_' ULID O1 . <br /> Unplatled Description: Sewer Bond District <br /> •:. , <br /> F�4 <br /> '� Aburiing Lot L(ne <br /> �'.TAN� <br /> �I L.f�'��� <br /> ��' N,S, E�W ft. <br /> 1 Type of Permit Nev conneetion Approved By <br /> GB <br /> � Remarks Issued By <br /> �� CustomerSignature � � �� <br /> I� IMPORTANTI <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING . <br /> Inspection 8y ��'�"^" <br /> CALL 259-8810 FOR INSPECTION 3_ ,i�y3 <br /> Date Inspected <br /> SEE SKETCH A7TACHED ; -. ,, � �, <br /> INSPECTION ' ' " ' <br />