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.__------�-,--- --.-- ---- <br /> --- --- <br /> �,.r�-�.,�,.,.- i <br /> , - t0 POSTI N � — _ I CHART N0. -- i <br /> 6��.9.� i <br /> � <br /> - II <br /> I �� ; ._ �., ; � - _ � i <br /> �. �z - <br /> ���� � - - �_ - � �� <br /> , ' i <br /> Sewer Appl'�cation ar�d,Perrr�it <br /> � . _ -� <br /> : , <br /> _ , <br /> - , ,� � , . _ � <br /> �9 0 G ;'t _; ,, ,DATE;,: ::. :-i%i4793 _ I�. <br /> � A��� <br /> 5425 lec Dz- SE UtiliryAccountNo. � <br /> Service Address j <br /> Billing Address 14410 Bel–Red Rd 4200 I <br /> Bellavue 1iA 98007 permit Fee $ 70.00 i <br /> City, State,Zip I <br /> Owner Colon� 'raft Connection Charge - � <br /> Connection by d �, ` Trunk $ , <br /> Address Lateral $ — � <br /> 0.00 � <br /> Total Connection Charge $ <br /> Phone Utility Devetopment Fee <br /> i Legal Description: <br /> Water g 179.U0 i <br /> Lot Zd Sewer $ i, <br /> 179.00 <br /> Block Tolal Development Fee $ � <br /> Plat Elanabrook lliv II ; <br /> ULID C1 � <br /> Unplatted Description: Sewer Bond Dlstrict � <br /> Abutting Lot Line � <br /> N,S, E,W n� I <br /> Type of Permit yea cooneccion ppproved By i <br /> GE I <br /> Remarks Issued By I �I <br /> Customer Signature` � � � ' `n �{ � <br /> ,� <br /> � <br /> IMPORTANT! i <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOIi TO DIGGING / I <br /> Inspection By �h���Yll r1 <br /> CALL 259-8810 FOR INSPECTION p? —,L 3 —<j j ' <br /> Date Inspected <br /> r i <br /> SEE SKETCH ATTACHED ? g(; G� <br /> INSPECTION " <br />