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CHART NO. <br />ifl POSTING ��� <br />8888BB 8 88 <br />Sewer Applicatiomand Permit. <br />4�N <br />29 144 DATEF A0/6y95 <br />Sarvice Address <br />4 elet st sw <br />Billing Address 1821 19th Dr <br />City, Slate, Zip r&+Ll•^ WA SR776' <br />Owner _ Alfred Juble <br />Connection by At4X i/n.2c <br />Address _ <br />Phone_ - <br />Legal Description: <br />Lot 9 SIP. 35-90 <br />Block <br />Plat —_ <br />Unplaned Description: —_ — <br />Type of Permit <br />Remarks <br />Nw connection <br />IMPORTANTI <br />CALL 1.800-424-5555 48-HOURS <br />Utility Account No. <br />Permit Fee S 70.00 <br />Connection Charge <br />Trunk <br />Lateral <br />Total Connection Charge <br />Utility Development Fee <br />Water <br />Sewer <br />Total Development Fee <br />S <br />S <br />s <br />.0- <br />9 _ 179.00 <br />6 471.00 <br />y 650.00 <br />Sewer Bond District <br />Abutting Lot Une <br />N. S. E, IN f4 <br />Approved By -- <br />Issued By ` <br />Customer Slgnatu) <br />PRIOR TO DIGGING <br />Inspection By <br />CALL 259.8810 FOR INSPECTION <br />Date Inspected <br />SEE SKETCH ATTACHED <br />NSP(MoN f'3 29444 <br />