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CHART NO. <br /> TO POSTING ��_'1 T <br /> a <br /> Sewer Application and Permjt <br /> � 'Ml <br /> 7 i i <br /> DATA2/15194 <br /> ' <br /> 2527 57th St SW <br /> Service Address Utility Account No. <br /> Billing Address 14410 Bel-Red Rd #200 <br /> City, State, Zip Bellevue 98007 Permit Fee $ _ 70.00 <br /> Owner __ Count=od Homes Connection Charge <br /> l / <br /> Connection by _ ? Q//e-6 Trunk $ <br /> Address Lateral <br /> -- — Total Connection Charge $ -0- <br /> Phone _ . Uti!ity Development Fee <br /> Legal Description: Water $ 224.00 <br /> Lot 45 Powdermill Oiv 2 Sewer $ <br /> Block Total Development Fee $ 224.00 <br /> Plat <br /> Unplatted Description: — Sewer Bond District <br /> Abutting Lot Line <br /> N. S. E, W K, <br /> Type of Permit New connection Approved By <br /> Remarks Issued By gb <br /> Customer Signature <br /> IMPORTANT! <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> CALL 259-8810 FOR INSPECTION Inspection By <br /> Date Inspected <br /> SEE SKETCH ATTACHED <br /> INSPECTION 2 9 h .5 <br />