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� <br /> IC�HARTNO. -- <br /> �ry � <br /> �yH <br /> p�1 5 <br /> (�" H <br /> 9 H tn <br /> K �C] � - . . . . . <br /> TO P(1STING__(_�--93-- <br /> o xa <br /> y N L'H <br /> � o� Sewe� Applicatioa� and Permit <br /> �3 t7 <br /> OH <br /> � �� , •, :, , -, DATE �/io/9: � <br /> �� � <br /> zH�'r�', '�z ServiceAddress 212� •7effcn,on t,vc UtiliryAccountNo. <br /> �y A2Ci 1tl1eC 1'1 Sld <br /> o �'H Billing Address <br /> f: d� Edu�onde WA 9d026 70.G0 <br /> .� �t. City, Stale,Zip Permit Fee $ <br /> E7 r� <br /> z `'-�' Owner Jameo �. Lcoroid Connection Charge <br /> H O tn <br /> Connection by — Trunk g 270.OD <br /> 450.00 <br /> Address Lateral S <br /> Tolal Connection Charge $ �Z0.00 <br /> �" `�� Phone Utiliry Development Fee <br /> � Legal Description: Water $ 179.00 <br /> p" "�� �at Sewer $ 471.00 <br /> ' Block Total Development Fee $ 65G.00 � <br /> _., .� <br /> Plat <br /> Unplatted Description: Sewer Bond District I1 <br /> � Abutting Lot Line <br /> -,.� <br /> NSEW ft. <br /> ,, <br /> ,,,, Type of Permit t7ew conneccion Appraved By ' <br /> GB <br /> Remarks Issued By ,I <br /> .�. � Customer Signature� �<< ' � <br /> , <br /> i <br /> IMPORTANT! ' <br /> ti_� ', <br /> CALL 1-S00-A24-5555 48-HOURS <br /> PRIOR TO DIGGING � I <br /> �' <br /> Inspection By �`� '. <br /> CALL 259-8810 FOR INSPECTION I <br /> Date Inspecled 9/�n /g�– i <br /> SEE SKETCH ATTACHED ' <br /> ir!s��t_ri ior� � <br />