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'.�A�N�TYTt•.WP^�.�o'.�ti•ti.c�... . ..• . . <br />� - �x r'; <br />i : � r_ . <br />.;> <br />Sewer Applicatio:n_ and Permit <br />�: 2 9 5 51 .� :.,DATE � �:-8-93 <br />311s ueeswre L1ve <br />�� ��a Utility Acxount No. <br />Bilflrq Address 409 Fllbert <br />Lynn�ood 4i� 98036 <br />J�ART NO. <br />T�) P��jl'Ir <br />CRY� State, ZfP ' Permit Fee S <br />p�y�� _ uuisarvlce Corv Connection Cha�qe <br />Co�nectlo^ bY _ T�unk s <br />Address Lateral a <br />Phone <br />Lepd UescciPtlon: <br />lot <br />Blodc <br />Pl�t <br />Unpl�tbd Descripdon: <br />Typs of P�rmit CaP-o!f <br />R�muks <br />INIPORTANTI <br />CALL 1-801�4245555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />Total Connection Charpe S <br />Utility Development Fee <br />Water y <br />Sewer s <br />Total Developmern Fee S <br />Sewer Bond District <br />Abuttfnp Lot Une <br />N, S, E, W _ <br />Apptrn'ed 9y — <br />Issued Fy <br />Cuatomer Sipnature <br />Inspection Oy _ <br />Date Inspected <br />1U.00 <br />SEE SKETCH ATTACHED <br />INSPECTION � •, ? � 5 ,rj ' <br />n <br />v <br />