2001, 05-16 Permit App: 01003661 SewerProject Number: 01003661 Inv: 1
d Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/16/01 Page 1 of 1
Project Information:
Permit Use: SEWER CONNECTION - WEI LESLEY MANOR Contact: WALDORF CONSTRUCTION
Address: PO BOX 840
C - S - Z: NEWMAN LAKE, WA 99025
Setbacks: Front Left: Right: Rear: Phone: (509) 226-2055
Group Name:
Site Information: Project Name:
Plat Key: 001984 Name: PEPLINSKIS 1ST ADDITION District: H
Parcel Number: 45011.0404
SiteAddress. 4621 N LARCH RD
SPOKANE, WA 99206
Location:: SPO
Zoning: UR -3.5
Water District.
Block: Lot:
Urban Residential 3.5
Owner: Name: BLYTHE, DAVE
Address: 4621 N LARCH RD
SPOKANE, WA 99216
Hold: ❑
Area: 0 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Department Review
ENGINEER Road Obstruction
Released By(j,jr� /b—D
5 / � Hold Reasons:
1 Permit Conditions:
Permits•
Sewer Permit
Contractor: WALDORF CONSTRUCTION Firm: RICHARD WALDORF/WALDORF
Address: PO BOX 840 Phone: (509) 226-0880
NEWMAN LAKE, WA 99025
Item Description
SEWER CONNECTION
PROCESSING FEE
Units Unit Desc
1 NUMBER OF
1 Y OR BLANK
Fee Amount
$85.00
$15.00
Permit Total Fees: $100 00
Payment Summary:
Operator: MKC Printed By. MKC Print Date: 5/16/01
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Sewer Permit $100.00 $100.00 $0.00 $100 00
3100.00 $100.00
Notes: „
$0.00 $100.00