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2002, 05-01 Permit App: 02003198 Sewer..- Protect Number 02003198 Inn / Application Date. 5/1/21102 Page 1 of 2 THIS IS NOTA`.; PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use SEWER CONNECTION - LONGVIEW PUD Contact. HAYDEN ENTERPRISES Address: 3327 W INDIAN TRAIL RD #232 C - S - Z: SPOKANE, WA 99208 Setbacks: Front Leff Right: Rear Phone: (5119) 994-4691 Group Naas: Site Information: Project Name: Plat Key 1)1)6266 Name' LONGVIEW PUD District: G Parcel Number: 55192.0321 Block 2 Lot. 2 SiteAddress. 316 5 MANIFOLD LN GREENACRES, WA USA 9911 Location:: GRE Owner: Names HAYDEN ENTERPRISES Address. 17626 E 2ND GREENACRES WA 99016 Zoning' UR -3.5 Urban Residential 3.5 Water -District 008 CONSOLIDATED IRRG #1 Hold' ❑ Arca 6,489 Sq Ft Width- 54 Depth' 118 Right Of Way (ft). 32 Nbr of Bldgs. 1 Nbr of Dwellings. Review Information: Reti ew Review 1» Utilities Permits: Released By: Sewer Connection Permit Contractor NORM'S EXCAVATING Firm: NORM'S BOBCAT SERVICE Address: PO BOX 574 Phone: (509) 928-115811 VERADALE, WA 991137 Item Description SEWER CONNECTION PROCESSING FEE Units Unit Desc 1 NUMBER OF 1 Y OR BLANK Operator: RMB Printed By RMB Fee Amount $85.00 $ 15.00 Permit Total Fees: $100.00 Print Date: 5/1/2002 Project Number 02003198 Inv: 1 Application THIS IS NOT PERMIT Penalties will be assessed for commencing work without a permit Date: 5/1/2002 Page 2 of 2 Notes: Payment Summary: Permit Typc Sewer Connection Permit Fee Amount Invoice Amount $100 00 $100 00 $100.00 $100.00 Amount Paid $0.00 Amount Owing $100.00 $0 00 $I00.00 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 he complied with. Subsequent issuance of a permit shall not be con trued 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: RMB Printed By: RMB Print Date 5/1/2002