Laserfiche WebLink
rv�vrc..T.'.'a+Wfnc'peM'a1*- ._,x—T.- ��c+a..—,-�-'---'-^-.�-='.z —�--� •.. ; <br />4' <br />� � _ <br />� �, �. ��� .; Ir, ;q �? : �1 y3 �- <br />PI c�', �'i.: � 4. _ <br />2 3 <br />� Sew�r Applicat�on arad`,Perijnit ^; <br />, ,�rs� �s <br />��,.-1 j. 5,-- - _::,:-��� <br />� 242b5 _ ;: �:. ' �- _ �-_. _;_ I <br />DATE <br />6y7 97 <br />Service Address 5917 3rd Dr H <br />BillinpAddross — 237 Elm St <br />Clty, S18�e, Zip Mere[t WA 982U3 <br />Owner c.i.,.r u <br />Connaclion by <br />Address _ <br />Phone <br />Lepel Descnp�ion: <br />Lo� ^_4 <br />Block <br />P1e� _ IlnnaGrook Uiv 3 <br />Unplatled Descriptlon: <br />TypeolPermit �l.v con„e�rio <br />Remarks _ <br />IMPORTANT! <br />CALL 1-800-424•5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259•8810 FOR INSPECTION <br />SEE SKETCH ATfACHED <br />Utility Account No. <br />CHART N0. <br />TO POSTING �a otr-93 <br />Permit Fee Si __ <br />Connectlon Charge <br />Trunk $ <br />Laleral $ <br />Talel Ccnnection Charga $ <br />Utility Development Fee <br />Water <br />Sewer <br />Total Development Fee <br />70.00 <br />-0- . <br />y 179.00 <br />S <br />a 179,00 <br />Sewer Bond District N'I� <br />Abutling Lol Line <br />N, S� E� W— --. ft. <br />Approved By <br />Issued By 6 <br />Customer Sipnature , � { � G �,� <br />Inspaction By 7- Z L-�1j <br />Date Inspecie� �`- v�� <br />INSPECTION � ^ (1 _„- <br />