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1i���:����i�'��� �..�..'�•�,. �*.��r��E,�iGI'?4�.i <br />+IIT ( <br />Sewer Appl <br />?.9593 <br />n <br />� <br />e; <br />r. k;s i��� a,L�i�`r'� •r '��:� <br />t� i- <br />r� Li Vi O• C 7� r� .: u �� ~� O�i <br />�c �. U: r+ .l �r. M -- .n �i u <br />M u� .� . <br />�n <br />icat n and.p t� �� �t� . <br />s1�- �����z���-��'-��`=-,� <br />�� � ���,,,.,�� , . _, <br />DATE 1/25/94 <br />SeMa� Addrese 24zs 1oi.c sc se <br />Billlrq Address _ 1U711 Bv�rgr��n 11r — <br />Clty, State, Zip ��r�tt 98204 _ <br />p�y�� L i L Buildar� <br />Connxtlon by _ <br />Ad�lreae <br />, <br />-' -- -- <br />Phone _ <br />i.eqel Deecrlptlon: <br />�t _ 4. Ei�anhowr N <br />Blodc <br />Plat _ <br />Unplened Dsecriptlon: <br />TypeolPermfl Nar conn�ctiou <br />Remerke _ <br />IMPORTANTI <br />CALL 1-800-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 25Y-861C FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Utllity Account Plo. <br />Permit Fee a <br />Connection Char�e <br />Trunk <br />La;erel <br />sG. ."'�i.? . d...JICi�''�*�i <br />CHART N0. —_ <br />TO POSTII'��-�-�_ <br />Totel Connectlon Cherpe <br />Utllity Development Fee <br />Weter <br />Eiewer <br />Totel Development Fee <br />70.00 <br />a <br />5--- <br />a -a <br />a <br />a <br />a <br />179.00 <br />a�i.00 <br />650.00 <br />Sewer Bond DleMct — <br />Abuttin�� Lot Llne <br />N, S, E, W ft. <br />Approved By <br />lasued By — Sb <br />Customer Signeture <br />i <br />Inepectlon By I <br />� <br />Dete Inspected i <br />INSPECTION <br />� 2959'' <br />� <br />