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b�<, l'��.F;' ;'_'�a;X.�'<.�':41*1�'�p�n�4.^45�M�'�w�y+,i'� ��M�"F'� . .. .s. �� �'�`��iw'�� <br /> � CHART NO. <br /> ��� TO �'C��TlNG��� -�� <br /> � <br /> a <br /> ,� <br /> n <br /> i � � � � � � � � � � <br /> `'1 rr,' r5 c� o M o � �n o � � <br /> �Y � R 'P ��t .w M ^ <br /> M .-+ M � � <br /> ��l <br /> Sewer Applicat',�:�► � ��aryrynd �� �r�piW� � � �. <br /> � � W U � �i. Y� ~ � C � uc -� � i <br /> f•J �t 4r t�. � :i: i.i [.- TC � J� <br /> ' ;� 29635 DATE . Z�Z�94 <br /> ., <br /> Service Address 5630 Ist Dr W _ Utility Account No. , <br /> Billing Addresa 237 Elm St <br /> 70.00 <br /> City,State,Zf{. 98203 Permit Fee $ .. <br /> Owner � Connection Charge <br /> Connectfon by �`� Trunk a <br /> Address Lateral S <br /> Total Connection Cha�ge S -a <br /> Phone Utiliry Development Fee <br /> lgyal pe9Cription: Water $ 179 00 <br /> �t 7 Huubrook Di� 4 Sewer a <br /> 179.On <br /> B� Total Development Fee S <br /> Plat <br /> Unplatted Description: <br /> Sewer Bond District ULID l l <br /> Abutting Lot Line <br /> NSEW ft. <br /> Type of Permlt Nev conn�ction Approved By <br /> IIb <br /> Remarks Issued By <br /> Customer Signature <br /> IMPOiiTANTI <br /> CNLL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING �.�� <br /> Inspectlon By ���=��' <br /> CALL 259-8810 FOR INSPECTIQN Dete Inspected � ���� <br /> SEE SKETCH ATTACHED � Z 9 6 3 � <br /> INSPECTION � <br />