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2002, 07-29 Permit App: 02006399 SewerProject Number: 02006399 hro: 1 Application Dale: 7/29/2002 Page 1 of 2 THIS IS1NO r A PERMIT Penalties will be assessed for commencing work without a permit Project I)tforn)tion: Permit Use. SEWER CONNECTION - WALLNU'I' Contact: SPECIALTY DIRT WORKS Address 482 DRAGON FLY DR C - S - Z: COEUR D'ALENE, 11) 83815 Setbacks: Front Left Right: Rear: Phone (208) 676-0967 Group Name Site Information: Project Name. PIM Key. 001834 Name OPP.TR. 1-354 District' F Parcel Number 45173.0810 Block Lot. SiteAddress 416 N LOCUST RD SPOKANE, \VA USA 000011 Location:. SPO Zoning: UR -3.5 Water District Urban Residential 3.5 Arca. 19,200 Sq Ft Width. 0 Nbr of Bldgs' 0 Nbr of Dwellings. 0 Review Information: Owner Name' GORDON. HARI,EY Address 416 N LOCUST RD SPOKANE, WA 99206-3869 Hold: ❑ Depth: 0 Right Of Way (CO 0 Review Road Obstruction Permits: _245 St. 4 t -B Sewer Cmureetiun Permit Contractor. SPECIALTY DIRT WORKS Firm: SPECIALTY DIRT WORKS Address: 482 DRAGON FLY Phone: (2118) 929-1494 COEUR D'ALENE, ID 83815 Item Description • Units Unit Desc Fee Amount SEWER CONNECTION I NUMBER OF $85.110 PROCESSING FEE 1 Y OR BLANK 515 00 Operator: RMB Printed By RMB Permit Total Fees: $100 00 Print Date: 7/29/2002 Project Number: 02006399 lnv: 7 Application THIS IS NOT A PERMIT Penalties will be assessed for ci;mmoncing work without a permit Date: 7/29/2002 Page 2 of 2 Notes: Payment Summary: Permit Type Sewer Connection Permit Fcc Amount Invoice Amount Amount Paid Amount Owing $100.00 $100.00 $0 00 $100.00 $10000 $100.00 $0.00 $100 00 Disclaimer: Submittal of this application certifies the owner (or person(%) authorized by the owner) has both examined and finds the information contained within to he 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 he contrued to he 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. RMB Pnnted By: RMB Print Date: 7/29/2002