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2002, 06-19 Permit App: 02004951 SewerProject Number: 0200-1951 Inv: Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Date: 6/19/2002 Page 1 of 2 • Permit Use: SEWER CONNECTION - CHINOOK Contact: PERFECTION PLUMBING Address: 5616 W VISTA GRANDE DR C - S - Z: OTIS ORCHARDS, WA 99027 Setbacks: Front Left: Right: Rear: Phone: (509) 921-0275 Group Name: Site Information: Project Name: Plat Key: 005426 Name: CHINOOK NO. 2 (CHINOOK ESTATES) District: H ••• • 1••, ••••, •• • Parcel Number: 46364.0507 Block: Lot: SiteAddress: 4804 N CONKLIN RD SPOKANE, WA USA 00000 Location:: SPO Zoning: UR -3.5 Water District: Urban Residential 3.5 Area: 13,788 Sq Ft Width: 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Information: Review Road Obstruction Permits: Owner: Name: MONAHAN, DALE J Address: 4804 N CONKLIN RD SPOKANE, WA 99216-1759 Hold: n Depth: 0 Right Of Way (ft): 0 .* ';•." . . . . — — I Released By: xi)01.4.0 Sewer Connection Permit Contractor: PERFECTION PLUMBING INC Address: 5616 N VISTA GRANDE DR OTIS ORCHARDS WA 99027 Item Description SEWER CONNECTION PROCESSING FEE Firm: PERFECTION PLUMBING INC Phone: (509) 218-8507 Units Unit Desc 1 NUMBER OF 1 Y OR BLANK Operator: RMB Printed By: RMB Permit Total Fees: Fee Amount $85.00 $15.00 $100.00 Print Date: 6/19/2002 Project Number: 0200-1951 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 6/19/2002 Page 2 of 2 Notes: MAXIMUM OF 30 RESIDENCES UNTIL WATER SYS I'BM COMPLETE PER FIRE DISTRICT 1 - JEF 11/18/94 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 $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: RMB Printed By: RMB Print Date: 6/19/2002