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p""^""`n`,-'�:�:':VP�..-'�r.-', . '^_'w_�^cY,��... . <br />��i . . .. ��- <br />Sewer Appl <br />� �- - - � � - - <br />,,. ; <br />ication arid Permit <br />DATE _ i/s/93 <br />Serv��Address 33 113th St ,;E <br />BillingAddress 4312 127ch P.�;:_ <br />Ciry, Stete, Zip r��a*erc WA _9H1[IA <br />Owner A�rsia�n ks6aF�� <br />Connection by __ <br />Address <br />Phone <br />Lepel Descriptlon: <br />Lot 2 <br />Block <br />Plel 9P 1202- <br />Unplatted Descrlptlon: _ <br />Type ol Permll i:av connection <br />Remarks <br />IMPORTANTI <br />CALL 1-800-424-5555 48•HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />I�HART NO. <br />p �OSTING $-Z�-9s <br />- - - r <br />�i <br />�' 'y M1 Y� 4 �O <br />� � F ��� <br />M y <br />.-. ... M <br />.. <br />� " ., �, <br />�� y.. � te � q � <br />t I.i � . <br />' . _ _ i :.. �..• <br />L • <br />Utility Account No. <br />PermitFee $ 70,00 <br />Connection Charge <br />Trunk $ _ 330.oa <br />Lateral $ <br />Total Cannection Charge $ 330.00 <br />Utillty Dovelopment Fee <br />Water $ 179.00 <br />Sewer $ 471.00 <br />Total Development Fee $ 650.00 <br />Sewer Bond Dlslrict <br />Abutt(ng Lot Line <br />N, S, E, W _ <br />Approved By _ <br />Issued By <br />Customer Signature <br />,i �Inspection <br />Date Inspected Q <br />SEE SKETCH ATTACHEO <br />INSPECTION � �' � �' <br />n <br />