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JJ P'4•lip'xkdArl;!,]ni '� J'•"►..1 ',.y�.'v'l,.{w l/'.�. y'�:Z,',T �i:{!�• .:\ "T�f+I.i„i1R�^'W"n "S`°' ' <br />CHART NO. <br />Sewer ppplicat <br />79,.r17 <br />01p8 <br />ti PI.V Epp [— 11 <br />t <br />ion an Prr� fs <br />DATE 4/22/93 <br />Service Address 605 92nd St so Utility Account No. <br />Billing Address 17032 35th AveSE <br />City, State, Zip _ Bothell WA 93012 Permit Feed (it� <br />Owner __ Lynn Laselay _ Connection Charge <br />Connection by _ Trunk <br />Address Lateral <br />Phone -- <br />Legal Description: <br />Lot 3 <br />Block _.— <br />Plat <br />Unplatted Description: <br />Type of Permit <br />Remarks _- <br />Lmerson Tracts <br />New connection <br />IMPORTANTI <br />CALL 1-800.424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />ppl1�-r <br />TO n.tw <br />1 M <br />Ir <br />Total Connection Charge <br />Utility Development F%,a <br />Water <br />Sewer <br />Total Development Fee <br />Sewer Bond District <br />Abutting Lot Line <br />N, S. E, W <br />Approved By <br />Issued By <br />Customer Slgnatuie <br />70.00 <br />$ 330.00 <br />$ 395.00 <br />$ 725.00 <br />$ 224.On <br />$ _ 589.00 <br />$ 813.99 <br />IIT <br />pb <br />_ ft. <br />Inspection By AO�� <br />Date Inspected <br />INSPFCTION <br />29SE2 <br />