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2002, 09-10 Permit App: 02007806 Sewer Project Number: 02007806 Inv: I Application Date: 9/10/2002 Page 1 of 2 THIS IS-r Ol-A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: SEWER CONNECTION-EASTON Contact: COURCHAINE EXCAVATION Address: 19818 E SPRAGUE C-S -Z: GREEENACRES,WA 99016 Setbacks:Front Left: Right: Rear: Phone: (509)924-5485 Group Name: Site Information: Project Name: Plat Key: 000000 Name: UNKNOWN District: F Parcel Number: 45162.0970 Block: Lot: SiteAddress: 11115 E DEAN AVE Owner:Name: AWBERRY, GARY SPOKANE,WA USA 00000 Address: 11115 E DEAN AVE Location:: SPO SPOKANE,WA 99206-5079 Zoning: UR-3.5 Urban Residential 3.5 Water District: Hold: ❑ Area: 10,370 Sq Ft Width: 0 Depth: 0 Right Of Way(ft): 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Information: Review Road Obstruction 't" Released RN. -� r O cS00`1 � Permits: .....::. .:::.....::::......... Sewer Connection Permit Contractor: COURCHAINE CONSTRUCTION Firm: COURCHAINE CONSTRUCTION Address: 19818 E SPRAGUE AVE Phone: (509)928-0846 GREENACRES,WA 99016 Item Description Units Unit Desc Fee Amount SEWER CONNECTION 1 NUMBER OF $85.00 PROCESSING NEE 1 Y OR BLANK $15.00 Permit Total Fees: $100.00 Operator: DMD Printed By: DMD Print Date: 9/10/2002 Project Number: 02007806 Inv: 1 Application Date: 9/10/2002 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Notes: Pa ment Summa : V Permit Type 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 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 construed 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: DMD Printed By: DMD Print Date: 9/10/2002