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CHART N0. ------- <br /> � �� ro ��ST���r _ ���? <br /> � �� <br /> t" H(A <br /> � <br /> � y� Sewer Application and Permit <br /> "'�� H'� .. � � -� . : . � � _ �: - <br /> NM <br /> � �� ? :? ' : -: DATE 5/5/93 — <br /> e <br /> �'1 SBUi� ls[ llr li <br /> � �g �ervice Address . Utiliry Account No. <br /> Q� n 237 Elm SC <br /> x y� Billing Address <br /> �� y Lveratt Wh 98203 permitFee $ 70.00 <br /> City,State,Zip _ <br /> �d�' Owner �elccc ltor_es Connection Charge <br /> �y� Connection by s C E Trunk e <br /> HOfNA <br /> � Address Lateral $ — <br /> 0.00 <br /> Total Conneclion Charge $ <br /> � Phone Utiliry Deve!opment Fee <br /> i 178.60 <br /> � �� Legal Description: Water $ — ' <br /> Lol �3 Sewer $ <br /> i ._� Block Total Development Fee $ 179.OG <br /> L Plat �- F �' n� � <br /> t'C?t, <br /> � <br /> Unplatted Description: _ _ Sewer Bond District <br /> �� � Abutting Lot Line <br /> N,S, E,W �' <br /> s <br /> �00 Type ot Permit New conneceian Approved By <br /> Issued B _ ��, <br /> Remarks _ Y ; �,; ; `,;_ ��, , <br /> . ,. . j <br /> ' ___ Customer Signature , �_ <br /> ��. <br /> IMPORTANT! <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING (/,," / <br /> Inspectian By v��'r"'a"' <br /> CALL 259-8810 FOR INSPECTION � �� ; 3 <br /> Date Inspeded — – <br /> SEE SKETCH ATTACHED , <br /> WSPECTION - � � � � <br />