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'..�,�,.,,,p,..,.,�.�.. ,� --� -, <br />Sewer Appl <br />. ' 29976 <br />n <br />T ,�, �„ � -� � ,�, • .: - _ <br />�,; - - � �� < <:; - .-. . <br />,�c _ : �> . . ,.: ., . <br />� " <br />icati�n ansi ���ni.� �t <br />,_ „ � ,, :._ �a;t � _ ,, {���' �., y <br />s. �. I�a .: �-- � " l � (- �t�y f �t .4 <br />:� .Yt � 7. .�. T" .._ . L . , � ;F .. �!Y _� ._. <br />DATE _ A-t�-93 <br />Servlce Addresa 2626 101.t Gc aR _ <br />BtIIInpAddresa 2»10 l3let Sc SE <br />Clly, Stet9, Zlp _ Snohoe�ish NA 9A290 <br />��� Nen�on HONs <br />Connection by ___ -- <br />Addresa <br />Phone �38-�SB2 <br />Lepal Deacrlptlon: <br />�� 16 ot Ci��nhover Court <br />Blodc <br />Plet <br />Unplatted Deac�lptlon: <br />Type of PermR nw connection <br />Remarks <br />IMPORTANTI <br />CALL 1-800-424-5555 48-NOURS <br />PRIOR TO DIGGING <br />CALL 26Y�9810 FOR INSPECTION <br />Utiliry Account No. <br />CHART N0. <br />TO PQSTIHG � "?r� <br />PermltFee $ 70.00 <br />Connectloa Cherye <br />Trunk S _ <br />Laterel S - <br />Totel Cortnectbn Cherpe E _ <br />Utlllry Development Fee <br />Water S _ <br />Sewer S - <br />Total Developmerri Fee S _ <br />-�- <br />l?9.00 <br />471.00 <br />bsn.00 <br />Sewer Bond DlsMct — <br />Abuttlnp Lot Line <br />N, S, E, W — ft• <br />Approved By <br />Isaued 8y � • <br />.- .. -�:� f/� � f �E�s_ <br />Cusromer Slpneture ' �E — <br />Inapectlon �� <br />Date Inspected 7 <br />SEE SKETCH ATTACHED <br />INSPECTION �' 2 9 3 7 6 <br />