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._. n <br /> ' CHART NO. <br /> E3ggg � g ssU9 TO POST1NG -as _y__ <br /> Sewe,• Application and���� <br /> y+ �r IVB <br /> 2 41 r. " DATE �2a799' <br /> 2612 58th St 3H <br /> Service Address Utility Account No. — <br /> Billing Address 1, 410 Del—Red Rd 0200 <br /> City, Zi Bellevue WA 98007 70.00 <br /> Y p — Permit Fee $ <br /> Owner Countrywood Homes Connection Charge <br /> Connection by G'-A" Trunk $ <br /> Address Lateral $ <br /> 0.00 <br /> Total Connection Charge $ <br /> Phone Utility Development Fee <br /> ` Legal Description: Water $ 214.00 <br /> Lot _ 16 Sewer $ <br /> Block — Total Development Fee $ 224.00 <br /> Plat I'owder 11111 !Highlands <br /> Unplatted Description: SeNer Bond District <br /> I <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> Type of Permit _ Jry connection Approved By <br /> Remarks _ _ __. Issued By C.P. <br /> Customer Signature <br /> IMPORTANTI <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING / <br /> CALL 259-8810 FOR INSPECTION Inspection Byr/<���K <br /> Date Inspected (D ^ Y 53 <br /> SEE SKETCH ATTACHED <br /> INSPECTION 29159 <br /> J, <br />