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2002, 05-06 Permit App: 02003388 SewerProject Number: 02003388 Inv: l -Appiitation THIS IS NOT A PERMIT Date: 5/6/2002 Page 1 of 2 Penalties will be assessed for commencing work without a permit Project Information: Permit Use: SEWER CONNECTION - EASTON 2 Contact: COURCHAINE CONSTRUCTION Address: 19818 E SPRAGUE C - S - Z: GREENACRES, WA 99016 Setbacks: Front Left: Right: Rear: Phone: (509) 924-5485 Group Name: Site Information: Project Name: Plat Key: 001834 Name: OPP.TR. 1-354 District: F Parcel Number: 45162.0438 Block: Lot: SiteAddress: 10705 E BOONE AVE SPOKANE, WA USA 00000 Location:: SPO Zoning: UR -3.5 Water District: Urban Residential 3.5 Area: 8,580 Sq Ft Width: 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Information: Owner: Name: NGUYEN, DUNG TRI & THIAH C Address: 10705 E BOONE AVE SPOKANE, WA 99206-4801 Hold: ❑ Depth: 0 Right Of Way (ft): 0 Review Road Obstruction Permits: Sewer Connection Permit Contractor: COURCHAINE CONSTRUCTION Firm: COURCHAINE CONSTRUCTION Address: 19818 E SPRAGUE AVE GREENACRES, WA 99016 Item Description SEWER CONNECTION PROCESSING FEE Phone: (509) 928-0846 Units Unit Desc I NUMBER OF I Y OR BLANK Operator: RMB Printed By: RMB Permit Total Fees: Fee Amount $85.00 $15.00 $100.00 Print Date: 5/6/2002 Project Number: 02003388 Inv: 1 App'ieatio�1 THIS IS NOTA PERMIT Penalties will be assessed for commencing work without a permit Dale: 5/6/2002 Page 2 of 2 Notes: Payment Summary: Permit Type Sewer Connection Permit Fee Amount Invoice Amount Amount Paid Amount Owing $100.00 $100.00 $100.00 $100.00 $0.00 $0.00 $100.00 $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 he true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will he 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: RMB Printed By: RMB Print Date: 5/6/2002