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-� . - - <br /> '... . . ;� . �p •T,;. �1 :'I...R�r�an7`7'.-.ci,,., ' .. L .. t : ,;,�;' . � . T �d ��' . ( l.'.',�J . . <br /> . . .�..' . . . . . . , . .".'::. . . <br /> , �• CHART N0. — I <br /> '� r <br /> r r' <br /> x <br /> � � '�STING �-u � <br /> �F _. <br /> Cn c]: n r O 1.; � L`j i� i:i .. <br /> �,.�'� tL. un �� � �not <br />� `C, . •r O ci �r f_� -.J L't r� L _ <br /> .-� W ti: - : � i d O L1 I_ <br /> �.� _ , . n �.i 5 �i <br /> M .'� <br /> �� � � ! <br /> Sewer Applica�i�n an�F4?,�er�n.i� _. <br /> :i r�t i: �- � � r ' � � ta` -i r=' � <br /> O G `� [. V � C i � - � T b Y� [�� J . <br /> I _' r�. �'.? ? DATE _ 1/24/94 r <br />� Servico Address 10130 25th Avn DE Utility Account No. <br /> I <br /> Billing Address <br /> 13712 64Ch L`r SL I <br /> 70.00 <br /> Cfty, State, Zip Snohomiah 98290 Permit Fee $ <br /> Owner nau r�oot u.,mo� inc Connection Charge <br /> Connection by Trunk $— i <br /> Address Lateral $ I <br /> Total Connection Charge $ �� <br /> I <br /> Phone Utility Development Fee I <br /> Legal Description: Water $ I79.00 i <br /> � Lot 16, Eiaenhower W Sewer $ 471.00 i <br /> i <br /> Block Total Development Fee $ 650.00 <br /> Plat � <br /> Unplatted Description: — Sewer Bend District <br /> Abutting Lot Line <br /> N, S, E,W n• � � <br /> Type of Permit tyew connection Approved By I <br /> Remarks Issued By gb <br /> Customer Signature <br /> IMPORTANT! <br /> CALL 1-800-424-5555 4&HOURS <br /> I PRIOR TO DIGGING � <br /> I CALL 259-8810 FOR INSPECTION Inspection Ry <br /> Date Inspected <br /> SEE SKETCH ATTACHED <br /> INSPECTION � � �� � � <br /> �- --- — _ __ _ _ _ - ---- _ - _ <br /> _ _- --- - - <br />