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2010 122ND PL SE 2016-01-01 MF Import
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122ND PL SE
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2010
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2010 122ND PL SE 2016-01-01 MF Import
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Last modified
4/17/2017 7:49:11 AM
Creation date
4/14/2017 10:43:46 PM
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Template:
Address Document
Street Name
122ND PL SE
Street Number
2010
Imported From Microfiche
Yes
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;� i r ( -C� C�- l �o <br />��L�A� WATER DISTRICT RETAIN THIS COPr, <br />��> "�.� �' 2210 • 732nd SI. S.E. • Eraratl, wa eezo�»ee i HiS IS Y^' '�'^EIP <br />� =� � � (�1337.38N • FAX (2081337•1399 . . . , T� <br />0�7�89 <br />SIDE SEWER PERMIT <br />� The undenigned Owner hereby rnokes applicotion for o sewer connection to sewer malns of the District; <br />for property described as follows: <br />� <br />Legol Description: / � 7 <br />/ ! <br />��( ( I !i % ( � �i <br />, � � <br />� )����� <br />Address� /' <br />'� �.� �.. � �� r.1 <br />' <br />.........� ......... ........................ �................. <br />�'� �-��.. `" <br />............. ........... ... .. . �................... <br />Cost �� � �- �' � � <br />.. ......... .... /.. ........ .... `................ <br />The Owner hereby ogrees ro be b�und by all <br />rules and regulations, now In forco or as here- <br />inafter omended, of tha Sewer District. <br />; <br />, _ _, <br />r-- ,- ':� � <br />.....1.. � :.................................:..........-.. ................ <br />Owner's Signahire <br />. ....................................... <br />Owner's Moiling Address <br />Fe [31 � 1997 .......................�Billiny..Address -........................ <br />Contractor .......................................................s{IV�R�lG1;E.1N11�ER.DISI:...Ucense No.......................................................... <br />After installotion, the system shall be inspected by a representative of the District before cover�ng. The prop- <br />erty owncr sholl be resp9nsible for II oQera ions, malntenonce and repair of the side sewe�. � <br />, ^ , <br />Permit issucd by:.........`...�����....�.1...�./ . .......................................................Dote:....�..... ' j � � <br />............................ <br />
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