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SIpE SEWER PERMlT <br />FIRCREST SEWER DISTRICT <br />2210 132nd St. S.E. <br />EvereH, �Ma�h. 98204 <br />337-3647 <br />No 15a2 <br />:The undersigned Ovmer hereby makes application for a sewer connection to sewer mains of the District; <br />� for property described as fsllows: <br />� Legal Description: <br />� /F. ���� . .. . - .... � ._ _ " <br />Address: <br />� � � � �; _. <br />„ / � <br />,(.�.:-=- ...�....... <br />� -�-+ ' . <br />/' . /.. . ' ... ., l_,! _ , �'f.�'""r. <br />Assessment IJo.....--....•-•------•-..•� <br />.. ..L, . ./, J ., <br />,t� r <br />+�a <br />R <br />Thc Owner hereby agrees to be bound by oll <br />rules and regulations, now in force or as here- <br />inafter amended, of the SeW�r District. <br />_ , ! ,7•� .-_..... <br />.......T.. ��.%�:�j::3."..._:.'/""""...:;.:_....." <br />' Owner s Signature <br />`� ...�,....�....4 :............................ <br />.� � r ;, r r / .... . .................. <br />""'.._......."""" ............ . . <br />.......�..J..-----'•-•-....`... ,��II_ 'i �` I�%� O•.vner's Mailing Address <br />SIL�'ui U��E �;ii�ltii ui�T. ........................ <br />....... .... .... .. � ---............ <br />I "' <br />-�-� • .....................Billing--Address <br />.... .... ........--License No....-�------- �- -..._......_........--•�-----.._....._... <br />Contractor....... .....i ..:.::..:....i----..:.----..........---..... •---..... . . <br />After installation, the system shall be inspected by a representative of the District before covering. The prop- <br />er*.y uwner shall be responsible fcr all operations, mointenance and repair of the side sewer. <br />. — .> <br />i:. , , ` <:.... ........-�----•• ...............Dote:..._a.:'.: .i.::.�...l.`f................ <br />Permit issued by:....f.�.l:4!.:.:....;,:t'.........\:-..z`.:.... � ...._.�...... <br />/ <br />