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CHART N0. ------ <br /> t <br /> � T� POSTIti� g <br /> � �'tl = - �, /� <br /> �c �s - <br /> 9HV� . .,, ' . <br /> K�� Sewer Application an�! Permit ; __ ;; <br /> oxo <br /> '�I N '+d <br /> v�H � ._� . , �1 DATE 4/;,'��s <br /> � z� , <br /> y�`�.� :iRlt; le[ llr H � <br /> Service Ad�iress Ulility Account No. <br /> ��g �37 �� sz <br /> p" � Billin Address <br /> H 9 70.OG <br /> x H� LVerecc NA 98203 permi�Fee $ _ <br /> � Ciry,State,Zip <br /> g�'H Owner sniect t�omae. Connection Charge <br /> C] C7 N .— �+ <br /> ��� Connection by S�� � Trunk <br /> ��' Address Lateral $ <br /> N <br /> 0.00 <br /> Total Connecticn Charge $ <br /> .� Phone Utiliry Development Fee <br /> � Water $ 179.00 <br /> � Legal Description: <br /> C� Lot _ 31 Sewer $ <br /> Block <br /> Total Development Fee $ 179'�� — <br /> � <br /> � `� p�al Iiannbrook Uiv S <br /> ULI� �'1 <br /> Unplatted Description: Sewer Bond District <br /> ���' _ Abutting Lot Line <br /> N,S� E��' ft. <br /> �11 Type GF Pefmit I�ev connection Approved By <br /> � 6A <br /> Remarks Issued By �, <br /> Customer Signature — <br /> � IMPORTANT! <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING / <br /> Inspeciion By "'�l�' :•'�' <br /> CALL 259-8810 FOR INSPECTION y_J�_ �j <br /> Date Inspected <br /> SEE SKETCH A'iTACHED ,, j . � <br /> INSPECTION � <br />