2001, 12-27 Permit App: 01011062 SewerProject Number: 01011062 Inv: 1
'Application
Date: 12/27/01 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 - SP -1271-01 PARCEL A
Setbacks: Front
Left: Right: Rear:
Site Information:
Plat Key: 006200 Name: SP -1271-01
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Contact: FOLSOM EXCAVATING
Address: 16701 E VALLEYWAY
C - S - Z: VERADALE WA 99037
Phone: (509) 891-1232
Group Name:
Project Name:
District: F
Parcel Number: 45261.1633
Block:
SiteAddress: 2319 S MARCUS LN
VERADALE, WA USA 99037
Location:: VER
Zoning: UR -3.5 Urban Residential 3.5
Water District: 010 VERA
Lot: A
Owner: Name: DIAMOND ROCK CONSTRUCTIO
Address: 15706 E VALLEYWAY AVE
VERADALE WA 99037
Hold: ❑
Area: 0 Sq Ft Width: 105 Depth: 145 Right Of Way (ft): 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Review by Utilities
Permits:
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Contractor: FOLSOM EXCAVATING INC
Address: 16701 E VALLEYWAY AVE
VERADALE, WA 99037
Sewer Connection Permit
Firm: FOLSOM EXCAVATING
Phone: (509) 891-1232
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: $100.00
Operator: JAS Printed By: JAS Print Date: 12/27/01
Project Number: 01011062 Inv: 1
Application
Date: 12/27/01 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes • 7,144 t:. A" -
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: JAS Printed By: JAS
Print Date: 12/27/01