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CHART NO. <br /> TO POSTING �-`� <br /> 885! !� SSRS s sg <br /> Sewer A►ppllcatW andPgrmit p ' <br /> Z 6 rr. . . <br /> 29223l� � � ;k - <br /> q G�DATE` <br /> Service Address 2J / '"O 'R7y sLA I Utility Account No. <br /> Billing Address —_14410 BEL—RED RD <br /> City, State,Zip BELLEVUE NA 98007 Permit Fee $ 70.00 <br /> Owner //CODUNTRYHOOD HOMFS Connection Charge <br /> Connection b� /��a%� ti s Trunk $ <br /> Address =— Lar jral $ <br /> Total Connection Charge $ _0 <br /> Phono Utility Development Fee <br /> Legal Description: Water $ 224.00 <br /> Lot 09 2 <br /> S,wer $ <br /> Block Total Development Fee $ 224.00 <br /> Plat POWDERMILL HIGHLAND DIV 2 <br /> Unplatted Description: Sewer Bond District <br /> Abutting Lot Line <br /> N. S, E. W ft. <br /> Type of Permit NEW CONNECTTON <br /> Approved By <br /> Remarks <br /> Issued By <br /> Customer Signature <br /> IMPORTANTI <br /> i <br /> j 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 29228 <br />