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2002, 07-30 Permit Application: 02006425 Sewer ConnectProject Number: 02006425 Inv: 1 Application Date: 7/30/02 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: SEWER CONNECTION - EASTON Setbacks: Front Contact: COURCHAINE CONSTRUCTION Address: 19818 E SPRAGUE C - S - Z: GREENACRES, WA 99016 Left: Right: Rear: Phone: (509) 924 -5485 Group Name: Project Name: Site Information: Plat Key: 000699 Name: EASTON SUB District: F Parcel Number: 45163.0245 Block: 1 Lot: 1 SiteAddress: 11218 E ALKI AVE Owner: Name: MOHNEY, WILLIS SPOKANE, WA USA 00000 Address: PO BOX 168 Location:: SPO DAVENPORT, WA 99122 -0168 Zoning: UR -3.5 Water District: Urban Residential 3.5 Area: 9,850 Sq Ft Width: 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Information: Hold: ❑ Depth: 0 Right Of Way (ft): 0 Review Road Obstruction Permits: Released By: b2 S1 D taz ION Sewer Connection Permit Contractor: COURCHAINE CONSTRUCTION Firm: COURCHAINE CONSTRUCTION Address: 19818 E SPRAGUE AVE Phone: (509) 928 -0846 GREENACRES, WA 99016 Item Description SEWER CONNECTION PROCESSING FEE Units Unit Desc 1 NUMBER OF 1 Y OR BLANK Operator: CKF Printed By: CKF Fee Amount $85.00 $15.00 Permit Total Fees: $100.00 Print Date: 7/30/02 Project Number: 02006425 Inv: 1 Application • THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 7/30/02 Page 2 of 2 Notes: Payment Summarv: Permit Type Sewer Connection Permit Fee Amount Invoice Amount Amount Paid Amount Owing $100.00 $100.00 $0.00 $100.00 $100.00 $100.00 $0.00 $100.00 Disclaimer: Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be complied with. Subsequent issuance of a permit shall not be contrued to be a permit for, or an approval of, any violation of any of the provisions of the code or of any other state or local laws or ordinances. Signature: Operator: CKF Printed By: CKF Print Date: 7/30/02