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� ^-' 4 <br /> P� 1 ' <br /> :i . � <br /> E <br /> - _ -__-__- _ ' ---T. �z-- .. r - . <br /> ___ ' _-'_'". _...�-_" -_.. __ _" . ' �ti <br /> �--. 1„� .'�. . . , ... . <br /> ,., � �, G�"tRT NO. <br /> ° m pnSTINr �-�s��3 <br /> ��y 4 " = - _ <br /> ,1. _, <br /> y ,�. ��n 'S i' -z .? <br /> A'.C.7'+ ri ' .i .� :r .� r, ' <br /> I �-.� a i <br /> r '.�.y r . , c C- J .. '. <br />' y �"` Sewer Application;and�;P�rii�i� w n � � J <br /> K n c , �' , o c <br /> OxO G �nG . � _ , ��� � �r :� _ . � <br /> � x� 23�78 DATE^ : 9'1-9-- � - <br /> p H d 2942 Maple St. Utility Account No. — <br /> H �g Service Address <br /> �� C] SZ1 HIILl $CTCOS <br /> z H g Billing Address <br /> ''3�{ Seattle WA 96121 — PermitFee $ 10.00 <br /> � H y Ciry,State,Zip _ <br /> � �y Owner Grou llealth Connection Charge <br /> Trunk $ <br /> t+ Conneclion by <br /> y HO y Lateral $ <br /> Address <br /> ` '-�" Tolal Connection Charge $ <br /> Phone 448-2355 _. — Utility Deveiopment Fea <br /> Legal Desc�iption: <br /> Water $ <br /> �, 58 6 Soueh hal6fof L�t 59 Sewer $ <br /> Lot _--- <br /> Block 695 Total Development Fee $ <br /> � � of Evcracc <br /> �I Plat <br /> Unplatted Descrfption: Sewer Bond District <br /> Abutting Lot Line <br /> 1 N�S. E�W ft. <br /> �.�� A roved B <br /> .,. Type oi Pe�mit Cnp off PP Y <br /> M}f <br /> Remarks Issued By � �y�s L (.L• <br /> / � � Customer Signatur � ' '' ' <br /> IMPORTANTI <br /> 1��� <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> � Inspection By— <br /> CALL 259-8810 FOR INSPECTION Dato Inspected <br /> SEE SKETCH ATTACHED 2^ � � ^ <br /> INSPECTION <br /> I <br /> � <br /> , <br /> —� <br />