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��r;. _,.�-, �,,,-�: •,,� <br />':; <br />_:; <br />� <br />0 <br />� <br />; �� <br />G O <br />�-� ��.., <br />aP � � <br />.H <br />Sewer Applica#�n and Permit <br />o ��� <br />� = Z� �G? � DATE 10/19/93 <br />1629 Rainicr Av� <br />Service Address <br />Billing Address S� <br />CRy, State, Zip �reet WA 98201 <br />��r �ralyn Sid�naso <br />ConnecNon by nren Dl„�„�_g <br />Si15I3Y-S�PVi�i' <br />: v:'i-' . <br />rr <br />Utility Account No. <br />Permit Fee $ <br />Connection Charge <br />Tnink <br />CHART NO. <br />TO POST�Nf, �� z�-4�I <br />Address 1Sf1A I��7�..A �v� ennc c �. L$t8f8� <br />, o��� ,4e« n�a w <br />82�5 Total Connection Charge <br />Phone �-�� Un��.y Development Fee <br />Lepal Descriptfon: • Water <br />Lot sewer <br />� <br />Plat <br />Unplatted Descriptlon: <br />Type of Permit �taration/Yi*�ir <br />Rema�ics <br />Q.'.�.i�i,i.i_Lr� <br />CALL 1-800-4245555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259�8910 FOR INSPECTIClN <br />SEE SKETCH ATTACHED <br />Total Development Fee <br />a <br />a <br />a <br />a <br />a <br />a <br />30.00 <br />Sewer Bond District <br />Abuttinp Lot Une <br />N, S, E, W n� <br />Approved By <br />issued By _T Sb -- <br />-- ) ' <br />CusromerSignature, ,!�y' , - � ��� 1'r� '`� <br />,J �y,�ee�o.... <br />I�N � <br />��' <br />Inspection By _ <br />Date Inspected <br />INSPECTION <br />' 294u2 <br />