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I _,. . _ _ <br /> _ .,,�,. . _. _: .�. . ,_.._ , <br /> CHART N0. — <br /> , <br /> � <br /> ; t TO P05TItJG _�=Z� <br /> ', Sewer Application and Per�nit <br /> � <br /> � ' ':, 28$2�' DATE J`�r za� i°�Z <br /> Service Address 10207 - 19th ave SE Utiliry Account No. <br /> Billing Address `"" "� """-"` u•'� Wav <br /> City, State,Zip <br /> g�ras�etE WA 98200 PB�mit Fee $ 30.06 <br /> I Owner palisadn rrop�rti.as Connectfon Charge , <br /> Connection by �'"r �— Trunk $ <br /> Address Lateral $ <br /> • Total Connectfon Charge $ <br />'.a 't <br />� <br /> Phone 35g-8220 Utility Development Fee <br /> f <br /> LegalDescription: Water u., ,$�q, 3:(�FM Oi'�Pksoyc kl:ki. <br /> � � Sewer $ .' <br /> LOt IhJ ^�:D <br /> Total Development Fee �;��� , <br /> Block " <br /> i,NfCl; i30.CA <br /> Plat <br /> Unplatted Description: Sewer Bond District <br /> Abutting Lot Lfne <br /> N,S, E,W n' <br /> Type ot Permit uTB�TioN Approved 8y <br /> Remarks Issued By J 13ock� ir 1� <br /> / <br /> Customer Signature � 1 <br /> IMPORTANT! <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> Inspection By <br /> CALL 259-8810 FOR INSPECTION i <br /> Date Inspacted <br /> SEE SKETCH AlTACHED ,,,3 2 n � �� <br /> INSPECTION <br />