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2001, 11-26 Permit App: 01010365 MHProject Number: 01010365 Inv: 1 Application Date: 11/26/01 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: suesessonneessierarnr Permit Use: DOUBLE WIDE MOBILE HOME Setbacks: Front 30 Left: 15 Right: 5 Rear: 24+ Site Information: Plat Key: 000498 Name: CORBIN ADD TO GREENACRES Contact: ORR, EDWIN R Address: 608 N GREENACRES RD C - S - Z: GREENACRES, WA 99016-9536 Phone: (509) 924-4723 Group Name: Project Name: District: G Parcel Number: 55184.1007 Block: 10 Lot: 9 SiteAddress: 702 N GREENACRES RD GREENACRES, WA USA 9901 Location:: GRE Zoning: UR -3.5 Water District: Area: 14,000 Sq Ft Nbr of Bldgs: 1 Urban Residential 3.5 Owner: Name: ORR, EDWIN R Address: 608 N GREENACRES RD GREENACRES, WA 99016-9536 Hold: ❑ Width: 100 Depth: 160 Right Of Way (ft): 50 Nbr of Dwellings: 1 Review Information: Review Site Plan Review Plan Septic System Review Permits: Operator: CKF Printed By: Print Date: Project Number: 01010365 Inv: 1 1 , 'Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 11/26/01 Page 2 of 2 Manufactured Home Contractor: OWNER Firm: OWNER Address: 0 Phone: (000) 000-0000 000000, 00 000000 Item Description INSPECTION FEE COUNTY SURCHARGE Units Unit Desc 2 SECTIONS 1 Y OR BLANK Permit Total Fees: Fee Amount $100.00 $22.00 $122.00 Notes Payment Summary: Permit Type Manufactured Home Fee Amount Invoice Amount Amount Paid Amount Owing $122.00 $122.00 $0.00 $122.00 $122.00 $122.00 $0.00 $122.00 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: CKF Printed By: Print Date: Project Number: 01010365 Inv: 1 • Application Date: 11/26/01 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: DOUBLE WIDE MOBILE HOME Setbacks: Front 30 Site Information: Contact: ORR, EDWIN R Address: 608 N GREENACRES RD C - S - Z: GREENACRES, WA 99016-9536 Left: 15 Right: 5 Rear: 24+ Phone: (509) 924-4723 Group Name: Project Name: Plat Key: 000498 Name: CORBIN ADD TO GREENACRES District: G Parcel Number: 55184.1007 Block: 10 SiteAddress: 702 N GREENACRES RD GREENACRES, WA USA 9901 Location:: GRE Zoning: UR -3.5 Water District: Area: 14,000 Sq Ft Urban Residential 3.5 Lot: 9 Owner: Name: ORR, EDWIN R Address: 608 N GREENACRES RD GREENACRES, WA 99016-9536 Hold: ❑ Width: 100 Depth: 160 Right Of Way (ft): 50 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Review Site Plan Review Plan Review Septic System Review &Avow systc:r4 cL iqr j bedrooras Permits: Operator: CKF Released By: Released By: Printed By: Print Date: