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-------- - --- - - - ----- <br /> ,_,-�- . __.� ;. ..�� . <br /> ,f: . . . . <br /> CHART NO. — — <br /> � TO PQ$TING ro-z6-v� <br /> n � <br /> - - -, �, <br /> `i= _ : <br /> Sewer Applicatio�_ and Permit <br /> 29'_?3 DATE'c: " 5/17/53 �, <br /> Service Address 43i 40ch pl Utility Account Nu. <br /> Billing Address '+'4o r t k Av F <br /> City,State,Zip Seatcle WA 90102 permit Fee $ 70.00 <br /> Owner UAlly lloms Connection Charge <br /> Connection by ���� �e t�M.f �^-'^�- — Trunk 5 <br /> Address Lateral 3 <br /> Total Connection Charge S -�- <br /> Phona Utility Development Fee <br /> ' 224.00 <br /> Legal Description: Water 3 <br /> Lol 37 Sewer $ 589.00 _ <br /> Block Total Development Fea $ 813.00 <br /> Plat c�ioari�,..,n <br /> Unplatted Descriptlon: Sewer Bond District <br /> Abutling Lot Line <br /> N,S,E.W ° �' ft. <br /> Type of Permit Nev comection Approved By <br /> Remarks Issued By b . <br /> _ CustomerSignature.� � <br /> IMPORTANTI <br /> CALL 1-800-424-5555 48-HOURS �- <br /> PRIOR TA DIU'GING <br /> / <br /> , Inspeclion By � `�� �''y" <br /> CALL 259-8810 FOR INSPECTION <br /> Datelr.spected G-���'T <br /> SEE SKETCH ATTACHED <br /> INSPECTIOtJ -. ?��?�� <br />