2002, 07-18 Permit App: 02006042 SewerProject Number: 02006042 Inv: 1
-Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 7/18/02 Page 1 of 2
Project Information:
Permit Use: SEWER CONNECTION - SKYVIEW Contact: ALLIED SEWER & BORING
Address. 9317 S FREEMAN DR
C - S - Z: MEDICAL LAKE, WA 99022
Setbacks. Front Left: Right: Rear: Phone: (509) 924-8508
Group Name:
Site Information: Project Name:
Plat Key: 002392 Name: SKYVIEW ACRES ADD District: F
Parcel Number: 45284.1834 Block: Lot:
SiteAddress: 3016 5 BATES RD
SI'OKAiNE, WA USA 99200
Location:: SPO
Zoning UNKN Unknown
Water District.
Owner: Nance: CHAMBERLAIN, FRED .1 & SHER
Address. 3016 S BATES RD
SPOKANE, WA 99206-5932
Hold ❑
Area: .00 Acres Width. 0 Depth: 0 Right Of Way (ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information: ,
Review
Road Obstruction
_oast.4 589
Permits: ,
Released 13y:
Scoter Connection Permit
Contractor: ALLIED SEWER BORING Firm: ALLIED SEWER BORING COM PA
Address: 9317 S FREEMAN 1)12
MEDICAL LAKE. WA 99022
Item Description
SEWER CONNECTION
PROCESSING FEE
Phone (509) 924-8508
Units Unit Desc
1 NUMBER OF
1 S OR BLANK
Operator: JAS Printed By JAS
Fee Amount
$85.00
$15 00
Permit Total Fees: 5100.00
Print Date: 7/18/02
Project Number: 02006042 Inv: 1
Application
Date: 7/18/02 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes:
Payment Summary.
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owine
Sewer Connection Permit $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: JAS Printed By: JAS
Print Dale: 7/18/02