2002, 02-28 Permit App: 02001153 SewerProject Number: 02001153 Inv: I Application Date: 2/26/2002 Page 1 of 2
v
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Proiect Information:
Permit Use: SEWER CONNECTION - DHAENENS SQUARE, Contact: MIKE PEPLINSKI
Address: PO BOX 178
C - S - Z: NEWMAN LAKE, WA 99025
Setbacks: Front Left: Right: Rear: Phone: (509) 994-9315
Group Name:
Site Information: Project Name:
...............
Plat Key: 005914 Name: DRAENENS SQUARE PHASE H District: F
Parcel Number: 45224.4406 Block: 5 Lot: 6
SiteAddress: 1429 S DAVIS LN Owner: Name: BRISBANE, DONALD N & MARIA
SPOKANE, WA USA 00000 Address: 22809 E COUNTRY VISTA DR APT
Location:: SPO LIBERTY LAKE, WA 99019
Zoning: UR-7 Urban Residential-7
Water District: Hold: ❑
Area: 6,351 Sq Ft Width: 59 Depth: 130 Right Of Way (ft): 30
Nbr of Bldgs: I Nbr of Dwellings: 1
Review Information: . ... ..
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Permits: .............. ......... ........ ..........
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Sewer Connection Permit
Contractor: MIKE PEPLINSKI
Address: PO BOX 178
NEWMAN LAKE, WA 99025
Item Description
SEWER CONNECTION
PROCESSING FEE
Firm: MIKE PEPLINSKI
Phone: (509) 226-3963
Units Unit Desc Fee Amount
I NUMBER OF $85.00
1 Y OR BLANK $15.00
Permit Total Fees: $100.00
Operator: RMB Printed By: RMB Print Date: 2/26/2002
Project Number: 02001153 Inv: / Application ' ~ Date: 2/I6/2002 Page 2oK2
THIS IS NOT A PERMIT
OK TO ISSUE SEWER PERMITS FOR BLOCK l- LOTS lTHl0, BLOCK 2- LOTS lTHl2PER
ROGER 10/23/98
D[) NOT ISSUE SEWER 9ERNUT8 FOR BLOCK 3- LOTS lT87. BLOCK 4- LOTS lTB5,
BLOCK 5- LOTS lTB6
PaymentSummatw :::^^::::.:;*;*;*;;.::;*;*^,:�*.^°^::.,;*;*,*;,^,;,::^°:^:::^;`�*.�^::;.�..,,,,,*`.,^,.,,,,�..,..,,,,,,,, ^°:::^;`. :::^:::,
Permit lype Fee Amount Invoice Amount Amount Paid Amount Owing
Sewer Connection Permit $100.00 $100.00 $0.00 $100.00
$100.00 $100.00 $0.00 $100.00
Submittal vf this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within mobe 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 vf any ofthe
provisions vf the code vrvf any other state vr local laws v,ordinances.
Signature:
Operator: RMB Printed By: RMB Print Date: 2/26/2002