2001, 12-27 Permit App: 01011065 SewerProject Number: 01011065 Inv: 1
Application
THIS IS NOT A PERMIT
Date: 12/27/01 Page 1 of 2
Penalties will be assessed for commencing work without a permit
Proiect Information:
WMPriiMSOMMINZMW
Permit Use: SEWER CONNECTION - SP -1271-01 PARCEL D Contact: FOLSOM EXCAVATING
Address: 16701 E VALLEYWAY
C - S - Z: VERADALE WA 99037
Setbacks: Front Left: Right: Rear: Phone: (509) 891-1232
Group Name:
Site Information: Project Name:
Plat Key: 006200 Name: SP -1271-01
District: F
Parcel Number: 45261.1633
Block:
Lot: D
SiteAddress: 2311 S MARCUS LN Owner: Name: DIAMOND ROCK CONSTRUCTIO
VERADALE, WA USA 99037 Address: 15706 E VALLEYWAY
Location:: VER VERADALE WA 99037
Zoning: UR -3.5 Urban Residential 3.5
Water District: 010 VERA Hold: ❑
Area: 15,426 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 20
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Review by Utilities
Permits:
Contractor: FOLSOM EXCAVATING INC
Address: 16701 E VALLEYWAY AVE
VERADALE, WA 99037
Item Description
SEWER CONNECTION
PROCESSING FEE
Sewer Connection Permit
Firm: FOLSOM EXCAVATING
Phone: (509) 891-1232
Units Unit Desc
1 NUMBER OF
1 Y OR BLANK
Fee Amount
$85.00
$15.00
Permit Total Fees: $100.00
Operator: JAS Printed By: Print Date:
Project Number; 01011005
Notes:
r �
Inv; -Al)pliention
Ditty' 11111101 Pogo 1 of 1
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Payment Summary: b>,„
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: JAS
Printed By: Print Date: