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2002, 07-16 Permit App: 02005956 SewerProject Number: 02005956 Inv: 1 Applicata op THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: SEWER CONNECTION - EASTON Contact: INLAND EXCAVATING & CONSTRUCTI Address: 3417 W OLSON RD C - S - Z: DEER PARK, WA 99006 Setbacks: Front Left: Right: Rear: Phone: (509) 276-8500 Group Name: Site Information: Project Name: Date: 7/16/02 Page 1 of 2 Plat Key: 001554 Name: MARION ADD District: F Parcel Number: 45162.1406 Block: 3 SiteAddress: 10920 E DIAXWELI, AVE SPOKANE, %VA USA 99206 Location:: SPO Zoning: UR -7 Nater District: Urban Residential -7 Lot: 6 Owner: Name: CARUTHERS. DIANA M Addicss 10920 E NIAX\YELL A\ E SPOKANE, WA 99206-2500 Hold: ❑ Area: .00 Acres Width: 0 Depth: 0 Right Of Way (ft): 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Information: . - - Review Road Obstruction Released By: el- /L Ga _0_2-.21 AAK-5--7G Permits: , Server Cmeuection Permit Contractor. INLAND EXCAVATING & CONST Firm: INLAND EXCAVATING & CONST Address: 3417 W OLSON RD Phone : (509) 276-8500 DEER PARK. WA 99006 Item Description SEWER CONNECTION PROCESSING FEE Units Unit Desc 1 NUMBER OF 1 Y OR BLANK Operator: CKF Printed By. CKF Fee Amount $85.00 515 00 Permit Total Fees: $100.00 Punt Date: 7/16/02 Project Number: 02005956 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 7/16/02 Page 2 of 2 Notes: Payment Summary: . , Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Sewer ConnectionPemut $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: 7/16/02