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'. <br />�?iw;, � . . .. �+�^l.n�T�.ryiR.��'�_.(id��r „�7i''�S � 'i�.�' <br />� Sewer Applica <br />29210 <br />�� <br />� <br />k <br />,� <br />� <br />L J Lti i� �l '.�Y � �� I.l <br />�4 � ,.: 4, _ - u �-� r'� . <br />t .a I � <br />tl 'i .,i �� _� .. ; [� <br />N � . <br />!' ' <br />tio�n and F���jr�nit <br />� � S{ 1� _l y l.l � W. � i" <br />F_; h ,., �_� �_. � ; � �� _. � � <br />�, ��'�'�';�_;�, �'•- . <br />r DATE 5-to-93 <br />ServlceAddrese 2409 l0,et St sE <br />Bllling Addresa 10711 Bvergreen Way <br />Clly, StetB, Zlp Pverett SIA 98204 <br />��� L 6 L suild�r� <br />Connectlon by �ar <br />Addrese <br />Phone 290-1818 <br />Lepel Deecriptlon: <br />�� B ot Eie�nhower Ct M <br />3bck <br />Plet <br />Unplatted Deec�iptlon: <br />Typ6 of Permll Mer conn�etlon <br />Remetks <br />IMPORTANTI <br />CALL 1-800-424•55�a5 48-HOURS <br />PRIOh TO DIGGING <br />CALL 259-8810 FOFi INSPECTION <br />SEE SKETC?I ATTACHED <br />Utility R,ccou�t No. <br />T_' ."' _�P�r-":?r'�T`���� <br />CHART N0. — <br />i <br />�, <br />i <br />TO P�triNr, �_�� , <br />Permlt Fee a 70_00 <br />Connection Chnrge <br />Trunk <br />Lateral <br />Totel Connectlon Cherpe <br />Ulllity Development t ae <br />Water <br />Sewer <br />T0181 DBvelOpmBnt FeB <br />Sewer Bond DlaMct <br />Aburiinp Lot Line <br />N, 5, E, W _ <br />Approved By _ <br />a <br />s <br />a <br />-tl- <br />a 179_OQ <br />a 4J1.00. <br />a 6�0.00 <br />�8811Bd �y � �—^ � � <br />Customer 3lgnature . <br />n. <br />InapecUon By ` — <br />Dete Inepected � <br />INSPECTION <br />u <br />� 29290 � <br />