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CHART NO. <br /> TO POSTING. 4- 27-q-A <br /> .� r_d a-a. r t- <br /> e M <br /> Sewer Application and Pyr w 't <br /> 4 DATE 2-15-94 <br /> Service Address 2524 57th St SW Utility Account No. <br /> BIIling Address 14410 Bel Red Rd 1200 <br /> - <br /> City, 'tate, Zip Bellevue WA 98007 _ Permit Fee $ 70.00 <br /> Owne. Cnontrywood Homes Connection Charge ti - 7- k I <br /> Connection by I "t eO Trunk $ <br /> Address Lateral $ — <br /> Total Connection Charge $ <br /> Phone Utility Development Fee <br /> Legal Description: Water $ 724.00 <br /> Lot 19 llt-wdi+r H!1] Liv Sewer $ --- <br /> Block Total Development Fee $ _ 11.24.00 <br /> Plat - <br /> I <br /> Unplatted Description: Sewer Bond District <br /> Abutting Lot Line <br /> N, S, E.W h. <br /> Type of permit nev connertloTi Approved By— <br /> Remarks _ Issued By ,tt, <br /> _— Customer Signature <br /> IMPORTANTI <br /> CALL 1-800-424.5555 48-HOURS <br /> PRIOR TO DIGGING /' <br /> Inspection By ���"I�^q <br /> CALL 259-8810 FOR INSPECTION <br /> Date Inspected y� fy <br /> SEE SKETCH ATTACHED <br /> INSPECTION 29649 <br />