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109 113TH ST SE 2016-01-01 MF Import
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109 113TH ST SE 2016-01-01 MF Import
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Last modified
4/27/2017 10:42:43 AM
Creation date
4/27/2017 10:42:41 AM
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Template:
Address Document
Street Name
113TH ST SE
Street Number
109
Imported From Microfiche
Yes
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T - �_ _ <br />�a-z-" . .. . .�—'.•�.--�-""_"_.'.n_�iT.. �nv__i_."_. ' '_T'. —T . . � <br />I�� : <br />Sewer Appli�ation and Permit <br />29011 DATE 1/s/`" <br />�09 <br />Service ,address � 113ch SC 6E <br />Bllling Addresa 4312 127th Pl SL' <br />City, State, Zip �e�rdcc v� oe nr. _ <br />Owner • + �.swc•• <br />Connectlon by <br />Address <br />Phone <br />Legel C�escription: <br />Lot 2 <br />Block — <br />Plet SP 1202-b992 <br />Unpletted Descriptlon: <br />Type of Permlt New eoanection <br />Remarks <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 />m <br />Utltity Account No. <br />- T ,�.__'_.` "'�- __'—__' <br />CHART N0. -__- <br />POSTIPiG � `�-c�0 <br />;, �_. <br />..�n:�� � '.�A4v7 <br />"` � M '�X <br />. � _ � <br />Permit Fee $ 70.00 <br />Connectlon Charge <br />Trunk $ 130.00 <br />Lateral S - <br />Total Connection Cherge $ 330. DC <br />Utility Development Fee <br />Water $ 179.00 <br />Sewer $ 471,00 <br />Tot.0 Development Fee $ b50 00 <br />III <br />Sewer Bond Distdct <br />Abutting Lo' Line <br />N, S, E, W n. <br />Approved By <br />Issued 0y— �g, <br />�� <br />Customer SignaWre ' "� � <br />� <br />i <br />/j'� ' I <br />Inspection BV_.. `GT' I <br />« <br />Dete Inspected � -�- 3 I <br />INSPECTION <br />Z9a�� <br />
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