2002, 07-18 Permit App: 02006066 SewerProject Number: 02006066 Inv: 1
AppiicafiUn
Date: 7/18/02 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: SEWER CONNECTION - SOUTH PONDEROSA Contact: COURCHAINE CONSTRUCTION
Address: 19818 E SPRAGUE
C - S - Z: GREENACRES, WA 99016
Setbacks: Front Left: Right. Rear: Phone. (509) 924-5485
Group Name:
Site Information: Project Name:
Plat Key: 000877 Name. FOREST MEADOW 1ST ADD
Parcel Number: 45333.1403
District: E
Block: Lot
SiteAddress: 4311 S HOLLOW CT Owner: Name: ABBAS. SALMAN
SPOKANE, 1VA 9920(, Address. 4311 S HOLLOW C1
Location:: SPO
Zoning UNKN
Water District -
Unknown
SPOKANE, WA 99206
Hold: ❑
Area: 0 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information: =tr.-
Review
--.-
Review
Road Obstruction
Permits: ,—
Released By:
Serer Connection Permit
Contractor: COURCHAINE CONS 1'RIJ(l'ION Firm: COURCHAINE CONSTRUCTION
Address: 19818 E SPRAGUE AVE Phone: (509) 928-0846
GREENACRES. WA 99016
Item Description
SEWER CONNECTION
PROCESSING FEE
I imus Unit Dcsc
I NUMBER OF
1 Y OR BLANK
Operator: JAS Printed 13y JAS
Fcc Amount
$85.00
$15.00
Permit Total Fees: $100.00
Print Date: 7/18/02
J
Project Number: 02006066 Inv: 7
Application
Date: 7/18/02 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes:
Payment Summary: , -
Penmt Type Fee Amount Invoice Amount Amount Paid Amount Owine
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 funds 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 JAS Printed 13y: JAS
Print Date: 7/18/02