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2002, 05-20 Permit App: 02003864 SewerProject Number: 02003864 Inv: 1 Anew Application THIS ISNOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 5/20/02 Page 1 of 2 Project Information: Permit Use: SEWER CONNECTION - EASTON 2 Contact: COURCHAINE CONSTRUCTION Address: 19818 E SPRAGUE C - S - Z: GREENACRES, WA 99016 Setbacks: Front Left: Right: Rear: Phone: (509) 924-5485 Group Name: Site Information: Project Name: Plat Key: 000986 Name: GILLINGHAM'S SUB Parcel Number: 45162.1046 Block: SiteAddress: 10913 E MALLON AVE SPOKANE, WA 99206 Location:: SPO Zoning: UR 3.5 Water District: Area: 0 Sq Ft Width: 138 Nbr of Bldgs: 1 Nbr of Dwellings: 0 Review Information: Review Road Obstruction Permits: non (.72-S t 1 3 ,MEM T. Aa AA . ABTM O District: F Lot: Owner: Name: CRAMS, CHARLIE Address: 10913 E MALLON AVE SPOKANE, WA 99206 Hold: ❑ Depth: 75 Right Of Way (ft): 50 Sewer Connection Permit Contractor: COURCHAINE CONSTRUCTION Firm: COURCHAINE CONSTRUCTION Address: 19818 E SPRAGUE AVE GREENACRES, WA 99016 Item Description SEWER CONNECTION PROCESSING FEE Phone: (509) 928-0846 Units Unit Desc 1 NUMBER OF 1 Y OR BLANK Operator: CKF Printed By: CKF Permit Total Fees: Fee Amount $85.00 $15.00 $100.00 Print Date: 5/20/02 Project Number: 02003864 Inv: 1 !ication THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 5/20/02 Page 2 of 2 Notes: Payment Summary ...,,, Permit Type Sewer Connection Permit Fee Amount Invoice Amount Amount Paid Amount Owing $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: CKF Printed By: CKF Print Date: 5/20/02