2002, 05-20 Permit App: 02003865 SewerProject Number: 02003865 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed folcommencing work without a permit
Date: 5/20/02 Page 1 of 2
Project Information:
Permit Use: SEWER CONNECTION - EASTON 2
Setbacks: Front
Site Information:
Left: Right: Rear:
•
Plat Key: CONV Name: CONVERTED CNTY DATA
Contact: COURCHAINE CONSTRUCTION
Address: 19818 E SPRAGUE
C - S - Z: GREENACRES, WA 99016
Phone: (509) 924-5485
Group Name:
Project Name:
District: F
Parcel Number: 45162.1049
Block:
SiteAddress: 11009 E MALLON AVE
SPOKANE, WA 99206
Location:: SPO
Zoning: AGSUB
Water District:
Area: 0 Sq Ft
Lot:
Owner: Name: GILLINGHAM, E MARSHALL
Address: 11009 E MALLON AVE
SPOKANE, WA 99206
Hold: ❑
Width: 102 Depth: 138 Right Of Way (ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 10
Review Information:
Review
Road Obstruction
Permits:
Released By:
cyZ S r D 3'1
Sewer Connection Permit
Contractor: COURCHAINE CONSTRUCTION
Address: 19818 E SPRAGUE AVE
GREENACRES, WA 99016
Item Description
SEWER CONNECTION
PROCESSING FEE
Firm: COURCHAINE CONSTRUCTION
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: 02003865 Inv: 1
Application
THIS IS NOTA PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/20/02 Page 2 of 2
Payment Summary: ~_....
Permit Type
Sewer Connection Permit
AMENNEIMMEMONOZ
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: 5/20/02