2002, 07-18 Permit App: 02006041 SewerProject Number: 02006041 Inv: 1
Appiication
THIS IS NOT A PERIVIIT
Penalties will be assessed for commencing work without a permit
Date: 7/18/02 Page 1 of 2
Project Information:
Permit Use: SEWER CONNECTION - EASTON Contact: ALLIED SEWER & BORING
Address 9317 S FREEMAN DR
C - S - Z: MEDICAL LAKE, WA 99022
Setbacks. Front Left: Right: Rear: Phone: (509) 924-8508
Group Name:
Site Information: Project Name:
Plat Key: 001554 Name: MARION ADD District: F
Parcel Number: 45162.1305 Block:
SiteAddress: 10925 E MAXWELL AVE
SPOKANE, )VA USA 99206
Location: SPO
Zoning: UNKN Unknown
\Vater District.
Area: .00 Acres Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Lot:
Owner: Name. EVANS. JEFFREY D & JULIE
Addu•ss. 13909 E 29771 AVE
VERADALE, WA 99037-9400
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Review
Road Obstruction
Permits:
6?SL? S68
--- Sewer Connection Perntit - -
Contractor. ALLIED SEWER BORING
Address- 9317 S FREEMAN DR
MEDICAL LAKE. SVA 99022
Item Description
SEWER CONNECTION
PROCESSING FEE
Firm: ALLIED SEWER BORING COMPA
Phone: (509) 924-8508
Units Unit Desc Fee Amount
1 NUMBER OF 385.00
1 Y OR BLANK 315 00
Permit Total Fees: 5100.00
Operator: JAS Printed By JAS
Print Date. 7/18/02
Project Number: 02006041
Inv: 1
,application
Date: 7/18/02 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes:
Payment Summary: ,
Permit Type
Sewer Connection Permit
Fee Amount Invoice Amount
$100.00 $100.00
5100.00 $100.00
Amount Paid
$0.00
Amount Owing
$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.
Sign81 ti re:
Operator. JAS Printed 13y: JAS Print Date: 7/18/02