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2002, 07-17 Permit App: 02005996 Sewer Project Number: 02005996 Inv: 1 ,cation Date: 7/17/2002 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-BASCETTA Contact: Z BEST CONSTRUCTION Address: P.O. BOX 13421 C-S-Z: SPOKANE WA 99213 Setbacks:Front Left: Right: Rear: Phone: (509)891-9949 Group Name: Site Information: Project Name: .:.............................:......................................................................................................................................................... Plat Key: 002876 Name: WEST VALLEY ADD NO.4 District: E Parcel Number: 45182.0122 Block: Lot: SiteAddress: 1419 N LEWIS RD Owner:Name: SMALL,BARBARA SPOKANE,WA 99212 Address: 1419 N LEWIS RD Location::SPO SPOKANE,WA 99212 Zoning: UR-3.5 Urban Residential 3.5 Water District: Hold: ❑ Area: 0 Sy Ft Width: 0 Depth: 0 Right Of Way(ft): 60 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Road Obstruction Released By: 1.. !7 -0 :: oa S z-5 I Sewer Connection Permit Contractor: Z BEST CONSTRUCTION Finn: Z BEST CONSTRUCTION Address: P 0 BOX 13241 AVE Phone: (509)891-9949 SPOKANE,WA 99213-3241 Item Description Units Unit Desc Fee Amount SEWER CONNECTION 1 NUMBER OF $85.00 PROCESSING FEE ". 1 Y OR BLANK $15.00 Permit Total Fees: $100.0(1 Operator: RMB Printed By: RMB Print Date: 7/17/2002 •-.J Project Number: 02005996 Inv: 1 •••...Application Date: 7/17/2002 Page Appllcatlon 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Notes: Pa ment Summa v ry Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing 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 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: RMB Printed By: RMB Print Date: 7/17/2002