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�� <br />u <br />--- — — -- — - .�, <br />CHART N0. <br />TO QQSTING� -�-_ Q�- <br />i:�����r,�;, , :�.�,rr�, ix��cr;i���,� ,,,, � <br />. . , „��n�.tsa�, . <br />Sewer Application and Permit E�� _�.� <br />2II9t33 <br />DATE lz/4/92 <br />Service Address �813 Granc Dr <br />Billing Address 5806 1/2 3rd rlva NW <br />City, State, Zip Santtle WA 9810i <br />Owne� Jeffruy Leitch <br />Connection by <br />Address <br />Phone <br />Legal Description: <br />Lot I <br />Block <br />P�e� — Sn k1-91 <br />Unplatted Description: <br />Type of Perr.,it New connectiun <br />Remarks llormnnt vater service <br />IMPORTANT! <br />CALL 1-800-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />� ,.��; �e�.� <br />ci�cH sso.a, � <br />FL;! CH 510.00 ' <br />iK;lN'71 4,:O.OD I <br />Utility Account No. �:rnn: noan i <br />ti;F)[s S7D.OQ <br />1;`IC,! i i7_0.00 � <br />1l71!5 ^9t!.ilii <br />Permit Fee $ �+nnno ,• r,n 70. 00 <br />I::��I�F i:;i.Or; � <br />Connection Charge <br />:;_c•: >�.;ds.so I <br />Trunk <br />$ 2io.oa <br />Lateral $ 450.00 i <br />Total Connection Charge $ �20.00 I <br />Utility Devetopment Fee <br />Water $ 27.00 i <br />Sewer $ 71.00 I <br />i <br />Total Development Fee g 99.00 <br />Sewer Bond District _ <br />Abutting Lot Line <br />N, S, E, W <br />Approved By <br />Issued By <br />Customer Slgnature _ <br />CS <br />,_ _ -- — - <br />l �� ,/ <br />Inspection B �s /-' � %/ <br />Date lnspected 3 �9//`� � <br />SEE SKETCH A'TTACHED <br />INSPECTION ? '' �2 � ? <br />p <br />a <br />