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�;��10.'���R�S'�^.'.rSd�Ty'41��.i(3'C,.�- �`�1�...1:t 7 �1 `rh'y'.�',f.t7-;''�ah nY��:. - ti,i�,s i <br />� <br />i � <br />r� �; <br />Se�nrer Application and Permit <br />�, <br />_.. �,, :; <br />;� _ �= <br />" 29G49 DATE � z/i5/94 <br />Service Address 5202 Narbeck Ave <br />BillingAddress 51�� �az6ock�va <br />City, StBte, Zfp �are[t WA 98203 <br />Owner Tierche Dilaard <br />Connection by �..� Marn�.. <br />Address <br />Phone <br />Legal Descriptfon: <br />Lot <br />Block <br />Plat <br />Unpiatted Description: <br />Type of PermiS New connection <br />Remarks <br />IMPORTANT! <br />CALL 1-800-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR lNSPECTION <br />SEE SKETCH ATTACIIED <br />i <br />Utilfty Account No. <br />CHART NO. <br />Tn P(1STING �-Z�-��r <br />Permit Fee $ <br />Connection Charge <br />Trunk $ <br />Lateral $ <br />Total Connection Charge $ <br />Utility Development Fee <br />Water $ <br />Sewer $ <br />Total Development Fee $ <br />Sewer Bond District <br />Abutting Lot Line <br />N, S, E, W _ <br />Approved By _ <br />Issued By <br />Customer Signature <br />Inspection By � �e/�� <br />Date Inspected �' � -'y <br />INSPECTION <br />70.00 <br />ULID <br />R. <br />° Z464n � <br />