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C ' '4RT NO. <br /> VL7T <br /> Sewer Application and Permit ; <br /> N2 . 29626 DATE 1/13/93 — <br /> Service Address 2625 59Lh St SW Utility Account No. <br /> Billing Address 14410 Bel-Red Rd 0200 <br /> City, State, Zip <br /> Bellevue WA 98007 Permit Fee $ 70.00 <br /> Owner roi nrrwnnd Nn - Connection Charge <br /> Connection by Trunk $ <br /> Address Lateral $ <br /> Total Connection Charge $— <br /> 0.00 <br /> Phone _— Utility Development Fee <br /> at Description: Water $ 224.00 <br /> Lot t t Sewer $— <br /> Block <br /> Total Development Fee $ 224.00 <br /> Fowder Mill highlands <br /> Plat — <br /> Unplatted Description: Sewer Bond District <br /> Abutting Lot Line <br /> N, S, E,W ft. <br /> Type of Permit Npw rnnnortin Approved By <br /> Remarks _ Issued By <br /> Customer Signature <br /> IMPORTANTI <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> CALL 259-8810 FOR INSPECTION Inspection By <br /> Dale Inspected <br /> SEE SKETCH ATTACHED No 29626 <br /> CUSTOMER COPY <br />