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/ . :� <br />d. <br />;, <br />Sewer Applicat <br />�;� <br />CHART NO. <br />;, <br />° TO POSTING� <br />� <br />� <br />�- �`r,�,�� � � ��o <br />� . . . <br />,.� �- .� ��. � a �� �� a � <br />c� � c, �-+ +► c a a � r c� r-- <br />'..l �;. e�`. W 4� CA �-t ti.-. IT <br />p cr N . :: i.a .-:• <br />� N � �j w <br />io� �nd P�r � V . <br />., <br />��. � �� <br />�� �, -,� � �:Y'e� .,;� <br />l'.1 C.7 � U G � M- C!— f'1 �. [�� 1+} <br />1;'] ac W i: ��'� � Gu t'�_t y� G'S�t '.'q_i C G� N f i <br />DATE 5�4l93 _ <br />Service Address 6 56th Pl SE <br />Billing Address 144I0 Bel-Red Rd <br />IInllewe <br />City, State, Zip � WA 9t3007 <br />Owner ���o„y rrAfc - <br />Connection by il �C � <br />A� ,•:ess <br />Phone — <br />Legal Description: <br />Lpt 71 <br />Block <br />p�a� Hana�rook Div fi <br />Unplatted Descriptlon: <br />Type of Pefmit New connaction <br />Remarks <br />11:9PORTANT! <br />CALL 1-8iJ0-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Utility Account No. <br />Permit Fee $ <br />Connection Charge <br />Ttunk $ <br />Lateral $ <br />Total Connection Charge $ <br />Utility Development Fee <br />Water $ <br />Sewer $ <br />Total Development Fee $ <br />�. <br />70.00 <br />179.00 <br />179.00 <br />Sewer Bond District <br />Abutting Lot Lirie <br />N, g� E, yy ft. <br />Approved By <br />Issued By �b <br />� <br />� � ' a��" f \ <br />Customer Signatur <br />Inspection By � ' � ��� ��� �s� <br />Date Inspected <" l' y 3 <br />INSPECTION <br />:` ?�19i? <br />