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• � � Y. . ... . . ��• • . . '� �.I <br /> CHART NO. <br /> , <br /> �� TO POSTING q��- R�_ �-�--- <br /> Sewer Application and Permit <br /> � ��� 29226 DATE _ /2� <br /> Service Address ''S �� � l�}�`�--� Utiliry Account No. <br /> BIIIfngAddress 1��10 BEL-RED RD <br /> 70.00 <br /> Cily, State,Zip BELLEWE NA 99007 Permit Fee $ <br /> COIANY CRAET Connection Cha�ge ' <br /> Owner <br /> �G� Trunk $ <br /> Connection by a <br /> _� Lateral <br /> Address -0_ <br /> Total Connectbn Charge E <br /> Phone Wlity Development Fee <br /> Water a 179.00 <br /> Lepal Description: <br /> ,(,� Sewer $ <br /> Lot � " 179.00 <br /> Total Development Fee 5 <br /> Bbdc <br /> P�t �}(/�AOOK DIV II <br /> Sewer Bond District <br /> m.rn <br /> Unplatted DesariPtion: _�: <br /> qbutting Lot Line <br /> n. <br /> N, S, E,W <br /> 7ype of Perm�t N� CONNECTION ppproved By � ^ <br /> � ` . <br /> IIssued By <br /> Remarks � ;'-�,��C.. <br /> Customer Signature � L <br /> IMPORTANTI � � � � � � �� �� � g � � � � � <br /> � r � � •D <br /> � ` � � . � � O � <br /> CALL 1-800-424-5555 48-F��flFrS n3 m rJ � x, � �� <br /> I � �. � <br /> PRIOR TO DIGGING�.»„ ,�`a a � °\ .r'..�' � F �� w � a o k'• �_ /i' <br /> 5 � r� +-� o � .�' II�L`13�ff$��s�-- <br /> CALL 259-8810 FOR INS P��Q� � � Dete spe ted� �Y�`'3 <br /> � <br /> i�3 <br /> SEE SKETCH ATTACHED .r ' : 2 9 2 2 6 <br /> INSPECTION ' ' <br /> � <br /> I --- -- <br />