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t' I <br /> J <br /> CHART NO. --- ----- <br /> – <br /> � � H <br /> TO POSTING_ _ <br /> HZH <br /> Sewer Application and Permit <br /> 'n H '* . ' <br /> NH <br /> y i'7 ' A ° DATE 4/7/93 _ <br /> Hing <br /> Service Address 26 59th Pl SW Utility Account No. — 1 <br /> n 0 237 Elm St <br /> H Billing Address <br /> 70.00 <br /> H y City,State,Zip Fverett WA 98101 Permit Fee $ <br /> rA <br /> M d CO Owner c r r+ Connection Charge <br /> q t' Connection by SC E Trunk $ <br /> tn <br /> q O m Address -- Lateral $ <br /> i 0.00 <br /> Total Connection Charge $ <br /> Phone Utility Development Fee <br /> Legal Description: Water $ 179.00 <br /> L Lot 42 Sewer $ <br /> Block Total Development Fee $ 179.00 _ <br /> !j Plat Nenebrook Div 3 <br /> Unpletted Description: Sewer Bond District of-Tn dl <br /> Abutting Lot Line <br /> N, S. E,W tt. <br /> 1� Type of Permit Nov connection Approved By <br /> _ cs <br /> Remarks _— Issued By - --- <br /> i <br /> _ Customer Signature <br /> �Q1i IMPORTANT! <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> CALL 259-8810 FOR INSPECTION InspectlonBy � <br /> Date Inspected :S;//Z/ -7 <br /> SEE SKETCH ATTACHED '7 9 141 <br /> 4 4 <br /> INSPECTION - <br /> L <br />