2002, 07-16 Permit App: 02005957 SewerProject Number: 02005957 Inv: I
rN.
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date 7/16/02 Page 1 of 2
Project Information:
_
Permit Use: SEWER CONNECTION - WALNUT Contact: INLAND EXCAVATING & CONSTRUCTI
Address: 3417 w OLSON RD
C - S - Z: DEER PARK, WA 99006
Setbacks: Front Left: Right: Rear: Phone: (509) 276-8500
Group Name:
Site Information: Project Name:
Plat Key: 001855 Name: OPPORTUNITY SUB.TR.99 District. F
Parcel Number: 45173.0414 Block:
SiteAddress: 605 N LOCUST RD
SPOKANE. 11 A 99208
Location:: SPO
Zoning: UNK
\Vater District
Area. 0 Sq Ft Width: 0 Depth: 0 Right Of Way (ftE 55
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Lot:
Owner Name: MOON. RAYMOND
Address. 605 N LOCUS 1 RD
SPOKANE, WA 99208
Hold: ❑
Review Information:
Review
Road Obstruction
o a 3MYN,57S
Review by Utilities Releasc- —I
Permits:
Sewer Connection Permit
Contractor: INLAND EXCAVATING & CONST Firm INLAND EXCAVATING & CONST
Address: 34171V OLSON RD Phone. (509) 276-8500
DEER PARK, \VA 99006
Item Desci Union
SEWER CONNECTION
PROCESSING FEE
Units Unit Desc
I NUMBER OF
I V OR BLANK
Permit Total Fees:
Fee Amount
$85.00
$15.00
$100.00
Operator: CKF Printed 13y. CKF Print Date: 7/16/02
Project Number: 02005957 Inv: I
Notes •
Application
Date: 7/16/02 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Payment Summary: c
Permit Type
Sewer Connection Permit
Fee Amount Invoice Amount
$100.00 $100.00
Amount Paid
$0.00
Amount Owing
$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 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: CKF Printed By: CKF
Print Date: 7/16/02