1999, 08-06 Permit App: 99004364 SewerProject Number: 99004364 Inv: I
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 8/6/99 Page 1 of 1
Proiect Information:
Permit Use: SEWER CONNECTION - MEADOWLAND
Setbacks:_ Front Left: Right: Rear:
Contact: CHRIS SWANSON/HOMESTE
Address: 312 S FARR RD
C - S - Z SPOKANE WA 99206
Phone: (509) 926-0755
Site Information:
Plat Key: 000000 Name: UNKNOWN District: F
Parcel Number: 45213.9063
SiteAddress: 1311 S GLENN RD Owner: Name: HOMESTEAD CONSTRUCTIO
Spokane, WA USA 99206 Address: 312 S FARR RD
Location:: SPO SPOKANE WA 99206
Zoning: UR -3.5 Urban Residential 3.5
Water District: 007 MODEL Hold: ❑
Area: 11,334 Sq Ft Width: 80 Depth: 141 Right Of Way (ft): 38
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Department
UTILITIES
Comments:
Permits:
Review
Sewer Review
Contractor: HOMESTEAD CONSTRUCTION
Address: 312 S FARR RD
SPOKANE, WA 99206
Sewer Permit
Firm: HOMESTEAD CONSTRUCTION
Phone: (509) 926-0755
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
Payment Summary::s4samm:.< <> .: avemms f m,« <> •.o.,,«s::... ., ssos*s >: .
Operator: JAS
Permit Type
Sewer Permit
Printed By: JDL
Print Date: 8/6/99
Fee Amount Invoice Amount
$100.00 $100.00
Amount Paid
$0.00
Amount Owing
$100.00
$100.00 $100.00 $0.00 $100.00
Notes: ; ,; .. r m. ,,m ., . : .. ..:.nom „4.„.
Date:
UTtuTIES DIVISION
IN. Bruce !taw's, P.E., Utilities Director
•
C O U N T Y
A DIVISION OF THE PUBLIC WORKS DEPARTME. -r
GENERAL FACILITIES CHARGE (GFC)
PAYMENT OPTION SELECTION RECORD
Site Address(es):
Parcel No(s):
•
Builder Name: OR Owner Name:
Payment Option Selected (Check One):
1. ( ) G'FC payment received at issuance of Sewer Connection Permit by
Division cf Utilities
.0-C -Co05tn�.
2. ( ) GFC payment in 24 equal monthly payments upon establishment cf Sewer Billing Account.
Complete one of the following statements.
a. Owner's Statement: I, understand that I will
be billed for the applicable GFC amount in 24 monthly installments. The monthly GFC
installments will be added to my monthly sewer service charges.
Owners Signature Date
Builder's Statement: I, . understand that
because I am selecting this option fcr payment of the GFC, that the purchaser cf the hcme will
be responsible fcr payment cf the applicable GFC in 24 equal monthly installments. I agree to
formally disclose to potential cuyers of the property that the GFC charges will Pe added to the
monthly sewer seniice billings as soon as billing comments.
Builders Authorized Representative's Signature Date
Spokane County,
Division of Utilities
1026 W. Broadway • Spokane, WA 99260-0130 • (509) 477-3604 FAX: (509) 4774715 TDO: (509) 324-3166
GFC Payment Option Form
Revised 1/26/99