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2001, 09-19 Permit App: 01008116 SewerProject Number. 01008116 Inv: 1 Application Date: 9/19/20111 Page 1 of 1 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: SEWER CONNECTION - WELLESLEY MANOR Contact NORM'S EXCAVATING Address. P.O. BOX 574 C - S - Z VERADALE, WA 99037 Setbacks: Front Left' Right: Rear: Phone: (509) 928-0580 Group Nance: Site Information: Project Name: Plat Kev. 002847 Name: WELLESLEY MANOR IST ADD District: Parcel Number: 45012.2411 Block: Lot. SiteAddress: 16003 E HEROY AVE Owner: Name: RANKIN, PAT SPOKANE, WA 99216 Address: 160113 E HEROY AVE Location: SPO Zoning: A Water District: SPOKANE, WA 99216 Hold: ❑ Area: 0 Sy Ft Width: 104 Depth: 115 Right Of Way (ft): 50 Nbr of Bldgs: 2 Nbr of Dwellings: 1 Review Information: Department Review ENGINEER Road Obstruction Hold Reasons: Permits: Permit Conditions: 0/ 5eCto act Server Connection Permit Contractor: NORM'S EXCAVATING Firm: NORM'S BOBCAT SERVICE Address: PO BOX 574 VERADALE, WA 99037 Itein Description SEWER CONNECTION PROCESSING FEE Payment Summary: . Operator: MKC Permit Type Sewer Connection Permit Notes: Phone: (509) 928-0580 Units Unit Desc 1 NUMBER OF 1 Y OR BLANK Printed By: MKC Fee Amount $85.00 $15.00 Permit Total Fees: $100.00 Print Date: 9/19/2001 Fee Amount Invoice Amount Amount Paid Amount Owing $100.00 $100.00 $0.00 $100.00 $100.00 $100.00 $0.00 $100.00