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. :�::' . <br />�� <br />, <br />� <br />,:: <br />,,-,_.. . ,..-,.r._ .�:,:._., ,�. <br />`` �I <br />'�ChIART NO j <br />,_ _ ,. <br />�i � ,, ;� ,��.„ <br />r _�i�'��ibuip g ; . . . <br />�= ' � r ���r. _ v� or„'. <br />(1 r�';,F!_ :r-� - `' ;p�'C; <br />. .n H .. ; � - �:J <br />�n <br />Sewer Applicatior�and Pe�rr�it`' �{�1 �� _ <br />t l �3 :J � 3 <br />i> �.. `J Z � �4 - -. � i.,[ _ lu ." <br />p yJ __ �.:, r` :_ u a:J'� _. <br />� ; ; �� ''7t1/93 _ _ :: t � � <br />;' 2�32? DATE — <br />6J23 beh Dr A _ Utility Account No. <br />Service Address <br />237 Llm St <br />TO POSTING i�____ ��9� �I <br />� <br />Billing Address 70.00 <br />City, State, Zip fvarecc h'A 98203 Permil Fee $ <br />Selecr �io�A — _ C.onnection Charge <br />Owner � <br />c� � �' Trunk <br />Connection by $ <br />Lateral <br />Address ----------- -0- <br />Phone <br />Legal Description: <br />Lot _-- <br />Block ----- <br />Plet �-- <br />Unplatted Desc�iption: <br />tiannbrook Liv 3 <br />Type ot Permit Nuv connectlon .— <br />Remarks <br />IMPORTANTI <br />CALL 1-800-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Total Connection Charge $ <br />Utility Development fee <br />Water $ 179.U0 <br />Sewer $ <br />174.00 <br />Tutal Development Fee $ <br />U�In <br />Sewer Bond District <br />Abutting LotLine <br />n. <br />N, S, E, W <br />Approved By _-- <br />b <br />IssuedeY— � r��i _, � <br />; �i 7�-� : y( aa.i, ' — <br />Customer Signature � � <br />I <br />Inspection By - ye/' `�° I <br />i <br />Dale Inspecled � -�3 I <br />i <br />INSPECTION <br />' ' 2932i <br />