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2001, 08-23 Permit App: 01007168 SewerProject Number: 01007168 Inv: 1 I Application THIS IS NOT A PERMIT Date: 8/23/2001 Penalties will be assessed for commencing work without a permit Project Information: .................................................................................................................................................... . Permit Use: SEWER CONNECTION - WELLESLEY MANOR Contact: VIETZKE EXCAVATING Address: 2011 S CRAIG RD C - S - Z: MEDICAL LAKE, WA. 99022 Setbacks: Front Left: Right: Rear: Phone: (509) 535-4814 Group Name: Site Information: Project Name: ............................................................................................................................... Plat Key: 001984 Name: PEPLINSKIS 1ST ADDITION District: 11 Parcel Number: 45011.0414 Block: SiteAddress: 16322 E LONGFELLOW AVE SPOKANE, WA USA 99216 Location:: SPO Zoning: UR -3.5 Water District: Urban Residential 3.5 Area: .00 Acres Width: 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Information: .; Lot: Owner: Name: Address: KOCH, DOUGLAS D & MICHELL 16322 E LONGFELLOW AVE SPOKANE, WA 99216-1519 Hold: ❑ Depth: 0 Right Of Way (ft): 0 Page 1 of 1 ......................... Department ENGINEER Hold Reasons: Permit Conditions: Review Road Obstruction dI SII3 5aCe Contractor: VIETZKE EXCAVATING Address: 2011 S CRAIG RD #1 MEDICAL LAKE, WA 99022 Item Description SEWER CONNECTION PROCESSING FEE Payment Summary: Operator: MKC Permit Type Sewer Connection Permit Sewer Connection Permit Firm: VIETZKE EXCAVATING Phone: (509) 244-9607 Units Unit Desc 1 NUMBER OF 1 Y OR BLANK Permit Total Fees: Fee Amount $85.00 $15.00 $100.00 Printed By: MKC Print Date: 8/23/2001 Fee Amount Invoice Amount $100.00 $100.00 $100.00 $100.00 Amount Paid Amount Owing $0.00 $100.00 $0.00 $100.00