2002, 06-10 Permit App: 02004612 SewerProject Number: 02004612 Inv: I
c i -t plication
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Dale: 6/10/201)2 Page 1 of 2
Project Information:
Permit Use: SEWER CONNECTION - EASTON
Setbacks: Front
Left: Right: Rear:
Site Information:
Plat Key: 01)1858 Name: OPPORTUNITY SUB.TR.121
Contact: H & S CONSTRUCTION
Address: 11817 E. VALLEYWAY AVE
C - S - Z: SPOKANE WA 9921)6
Phone: (509) 926-8964
Group Name:
Project Name:
District:
F
Parcel Number: 45162.0945
Block:
SiteAddress: 11022 E BOONE AVE
SPOKANE, WA 99206
Location:: SPO
Zoning: AGSUB
Water District:
Lot:
Owner: Name: ANDERSON, SCOTT
Address: 111)22 E BOONE AVE
SPOKANE, WA 99206
Hold: ❑
Area: 0 Sy Ft Width: 100 Depth: 139 Right Of Way (fl): II
Nbr of Bldgs: 0 Nbr of Dwellings: 1
Review Information:
Review
Road Obstruction
Released
Bi
n2,St-K) log
Permits: . .
Contractor: H & S CONSTRUCTION
Address: 11817 E VALLEYWAY AVE
SPOKANE, WA 99206
Item Description
SEWER CONNECTION
PROCESSING FEE
Sewer Connection Permit
Firm: H & S CONSTRUCTION
Phone: (509) 926-8964
Units Unit Dcsc
1 NUMBER OF
I Y OR BLANK
Operator: RMB Printed By: RMB
Fee Amount
585.00
515.00
Permit Total Fees: $101).00
Print Date: 6/10/2002
Project Number: 02004612 Inv: 1
Application
Date: 6/10/2002 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Payment Summary:
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 he
complied with. Subsequent issuance of a permit shall not be contrued to he 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 Dale: 6/10/2002