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.1 . .. . . J� . .. . . . . . ..: -r.. .- . .f.. ..�. .. .:a+a�. .�...r ..�.� . <br /> �. <br /> ,�, '�= CHART NO. _ ' <br /> ;'� <br /> r <br /> T TO POSTING � � � <br /> :� <br /> � <br /> � ,� �� � <br /> :� <br /> �. o � = .T <br /> � * ,, w , � <br /> � Sewer Applicati�n and ���e�-�riit .. <br /> •� 'J w �j � J j V <br /> . ... � 3 � ,. J _5 ,., <br /> � :7� ct = �:: rt <br /> . '.: 2�578 DATE 1 19-94 <br /> Service Address 12204 19eh Ave SE Utfliry Account No. <br /> Biliirp Address <br /> CRy,State,Zip Permit Fee $ 10.00 <br /> Owner uililaa Garhere Connection Charge <br /> ConnecHon by Trunk $ <br /> Address =3000 27th Ave SE Lateral $ <br /> Bothell WA 98021 Total Connection Charge $ <br /> Phone 489-8437 Utility Development Fee <br /> Leyal Description: Water $ <br /> �t Sewer $ <br /> ' f B�� — Total Development Fee S <br /> Piat <br /> ,. Unplatted Descripdon: Sewer Bond District <br /> Abutting Lot Line <br /> N,S, E,W R <br /> . Type of Pertnft Cap off Approved By <br /> Remarks Issued By <br /> � Customer Signature <br /> IMPORTANT! <br /> CALL 1-800-424-5555 4&HrJURS <br /> PRIOR TO DIGGING <br /> CALL 259-8810 FOR INSPECTION Inspection By <br /> Date Inspected <br /> SEE SKETCH ATTACHED <br /> INSPECTION `: Z a 5 i�g <br /> � . ._ ., , _. „ . <br />