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r i-3 rn <br />HEX <br />K f] <br />7tl <br />O <br />Hy� <br />Q <br />OH <br />'�H <br />l7 <br />GyJ�f]ZH <br />ry <br />H <br />1 <br />U <br />1 <br />U <br />171 <br />LIF <br />C <br />L ' <br />a <br />a <br />Sewer Application,an`d Pern�,it;.; F <br />n :Zj I.O <br />DATE 8/20/92 <br />4311 Olympic Blvd <br />Service Address <br />Billing Address PO Box 2355 <br />City, State, Zip Lynnwood WA 98036 <br />Owner Ilearthwood Homes <br />Connection by <br />Address <br />Phone <br />Legal Description: <br />Lot <br />Block <br />Plat _ <br />Unplatted Description: <br />Type of Permit New connection <br />Remarks <br />IMPORTANTI <br />CALL 1-800-424-5555 48-HOURS <br />Utility Account No. <br />Permit Fee $ <br />CHART NO. — <br />Tn PASTINGS-,z7-s� <br />Connection Charge <br />Trunk <br />Lateral <br />Total Connection Charge <br />Utility Development Fee <br />Water <br />Sewer <br />Total Development Fee <br />70,00 <br />$ 270.00 <br />$ 450.00_ <br />$ 720.00 <br />$ 179.00 <br />$ 471,00 <br />$ 650.00 <br />Sewer Bond District II <br />Aoutting Lot Line <br />N, S, E, W tt. <br />Approved By <br />Issued By Ji CB <br />Customer Signature <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION Inspection By �yJe�J"O^ <br />f- Date Inspected -fl3 <br />SEE SKETCH ATTACHED <br />INSPECTION <br />