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�..: : <br />� <br />,� <br />��� <br />;�x� <br />H Z� <br />� H� <br />� M'�1 <br />tA H <br />x <br />��v <br />��8 <br />t+ y � <br />M�) <br />N <br />� H <br />n �N <br />�oy <br />...�e�cr�eO- < ,. :, > ; _; n— r-�.. <br />. ..q1�^�r17r4�T('S'�r%�:.+'.h:"'T"+a�M".'+""��'�� ..•,-5...1�.:�:' : •., �.. - . <br />ICHART NO. — ----- <br />Sewer Application and Permit <br />7.90'S�: <br />DATE <br />� TO POSTING_ a-a-q;_ <br />;0p1 Nnlnut UtilityAccounlNo. <br />Service Address <br />2906 Ho t <br />Billing Address �0.00 <br />City, State, Zip Evnrr.:t WA 98201 Permit Fee $ <br />Tim 'xill tann❑n Connection Charge <br />pwner $ _ <br />Trunk <br />Connectian by $ <br />Lateral <br />Address <br />Total Connection Charge $ . <br />� 5 n_� g q p Utility Developmenl Fae <br />Phone $ <br />Water <br />Legal Description: $ <br />Sewer <br />Lot <br />Total Development Fee $ <br />Bfock <br />Plat <br />gawer Bond District <br />Unplatted Descriplion: <br />Aburiing Lol Line <br />N, S, E, W ---- <br />R<�pnir APProved By _�---- <br />7ype of Permil �,�; <br />Issued By _---�— <br />Remarks , � <br />Custemer Signature <br />IMPORTANTI <br />CALL 1-800-424•5555 48-HOURS <br />PRIOR TO DIGGING <br />i;pL� 259-8810 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Inspeclion By �"" '"`— <br />Date Inspected �' _ � �9j <br />INSPECTION <br />n. <br />x <br />