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� SIDE SEWER PERMfT �, � <br />SILVER LAKE WATEH DISTRlCT (j(??�52� <br />2216 132nd St. S.E. <br />FvemH. 'Wa�h. 98204 �~�'j� /� <br />r.1 357.3647 <br />,--� The undersigned Owner hereby mokes application fcr e sewer connection to sewer mains of the District; <br />for property described as follows: <br />� `1 <br />Legal Description: <br />The Cwner hereby agrees to be bound by all <br />niles and re�lation�, naw in force or as here- <br />inafter amended, of the Sewer /District. <br />i , /'.._ (:_��1 <br />f ,`. <br />�"� . f � <br />� <br />: i <br />....."'�.- ...........:...1........._l.......>.G:..............._.."".... <br />Address: - Owner's $igfioh�re <br />' , _. <br />... �1.../....:: . �..._........1.: : -�-------•-=-:--.•--•:-:-`,._...._.....--••• � � �---� ...............--•--�- /---.._............._........_..._..... , <br />�- <br />�� . � J '" ' ..................."""'.....""'"..........................._.........."" <br />..........:....................•- �---••--�--......................._................ , n_ �:���.� O e's Mailin Address <br />, . _ <br />Cost .......:...� :..:......... <br />(ii �t ].J i_CJ wn r g <br />SILVFP, 11+KE 1'vAltH.ui�T:-•-----••-------• .......................... <br />........... ...... ...... ........... <br />� . Billing Address <br />Contractor.......................•--......_...................--••••-----�--•�---•-•-••-•-...,...License tJo......••••••••......................_..__._.:....••-•-- <br />After ins"allation, the system shal! be i�spected by a representative of the District before covering. The prop- <br />erty owner shall be responsible for all operotions, maintenance and repair of the side sewer. <br />. � , �, , <br />Permit issued b l...!.?.'..:�.::. ' •--- �.:......._.'.:...,:.:•: -c.: :_:.� ............................Date:.........:. �::�......ct....5.............. <br />Y:-•::-.- •-•- <br />. <br />