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�, . ' . _ `ID:St',_ _ �rT .:ip;:"i . . '._�... �'�.. . � . . <br /> .,�., , �..— <br /> ,, CHART NO. ---- <br /> 3 <br /> b' <br /> s <br /> � t g �s g e ,� :�s �, s � -' ^`�STING 4/d9/3� <br /> � � �y J 1f1 • 1{ <br /> [Y�J n O.�-� � O i�t5 O '� �- �? <br /> .S lit M W M �� � � (" <br /> a � � ^` ; <br /> Sewer Applicatioi� anc��r�n� ,, � <br /> � 4 � f:ic) (3 ' G <br /> � �`� �i9�i� �h � xr _' <br /> ��w:� .,,a . . �,_� _. � :: ;_ <br /> 2916� p� 4/26/9J <br /> Service Address 5572 l�t �C Utility Actouni No. <br /> BillinQ Address 14410 Bal-Red Rd _ <br />� �` 70.00 <br /> Ciry,Stete,Zip 8�11•w• uA 98007 �G_ permit Fee 5 <br /> Owner � � •� ConnecllonCharge <br /> Connection by _ `L�—� Trunk E <br /> Address Leterel E — <br /> i Totel Connectbn Cherge S 0.00 <br /> Phone Utility Development Fee <br /> LeqalOescription: Water E 179.00 <br /> �t r.t Fewer E <br /> 179.00 <br /> � Bbck Total Development Fee E — <br /> � Nanabmok ➢iv II <br /> Pla� - -- <br /> Unplatted Description: Sewer Bond District �'� — <br /> ____ Abutling Lot Line <br /> N,S,E,W n• <br /> Type oi Permil N 1. Approved By <br /> Ab <br /> Remarks Issued By <br /> �i Customar Slgneturo <br /> IMPORTANTI <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> CALL 259$810 FOR INSPECTION �nspectio�ey ��'��•�•+�w� <br /> � � � Dete Inspected S- w�5 3 <br /> SEE SKETCH ATTACHED <br /> INSPECTION ' .. Z 9 1 E 9 <br />