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2001, 06-29 Permit App: 01005277 SewerProject Number: 01005277 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 6/29/2001 Page 1 of 2 Project Information: .................................................................................................................................................................................................. Permit Use: SEWER CONNECTION - SOUTH PONDEROSA Contact: SHORT SEPTIC SERVICE INC Address: 3350 WILLIAMS RD E C - S - Z: ALMIRA WA 99103 Setbacks: Front Left: Right: Rear: Phone: (509) 639-2393 Group Name: Site Information: Project Name: Plat Key: 000875 Name: FOREST MEADOW ADD District: E Parcel Number: 45333.0607 Block: Lot: SiteAddress: 4312 S FOREST MEADOWS DR Owner: Name: JEWETT, BOB SPOKANE, WA 99206 Address: 4312 S FOREST MEADOWS D Location:: SPO SPOKANE, WA 99206 Zoning: UNK Water District: Hold: ❑ Area: 0 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Information: .; Department Review UTILITIES Review by Utilities Hold Reasons: Permit Conditions: ENGINEER Hold Reasons: Permits: Road Obstruction Permit Conditions:6 j AL D Contractor: SHORT SEPTIC SERVICE INC Address: 3350 WILLIAMS RD E Phone: (509) 639-2393 ALMIRA WA 99103 Sewer Permit Firm: SHORT SEPTIC SERVICE INC Item Description Units Unit Desc Fee Amount SEWER CONNECTION 1 NUMBER OF $85.00 PROCESSING FEE 1 Y OR BLANK $15.00 Permit Total Fees: $100.00 Project Number: 01005277 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Payment Summa Operator: RMB Permit Type Sewer Permit Date: 6/29/2001 Printed By: RMB Print Date: 6/29/2001 Fee Amount Invoice Amount Amount Paid Amount Owing $100.00 $100.00 $0.00 $100.00 $100.00 $100.00 $0.00 $100.00 Page 2 of 2