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2002, 08-30 Permit App: 02007486 SewerProject Number: 02007486 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 8/30/02 Page 1 of 2 Project Information: Permit Use: SEWER CONNECTION - NIIDILOME EAST 3RD Contact: CLIFF SCHMITZ CONS'T'RUCTION Address: 16520 E SECRETARIAT C - S - Z: VERADALE, WA 99037 Setbacks: Front Left: Right: Rear. Phone: (509) 999-7733 Group Name: Site Information: Project Name: Plat Key: 006185 Name: MIDILONIE EAST 3RD District: F Parcel Number 45341.1908 Block: 5 Lot: 8 SiteAddress: 3513 S MCDONALI) ST SPOKANE, WA USA 00000 Location:: SPO Zoning• UR -3.5 Nater District Area: 10.000 Sq Ft Nbr of Bldgs: 1 Review Information: , Urban Residential 3.5 Width: 80 Nbr of Dwellings: 1 Owner: Name: CLIFF SCHMI'I'Z CONSTRUCTION Address 16520 E SECRETARIAT VERADALE, WA 99037 Hold: ❑ Depth: 125 Right Of Way (ft): 50 Review Review by Utilities Permits: Released By: 0 L -e-/ 9,2 Sewer Connection Permit Contractor: FOLSOM EXCAVATING INC Firm: FOLSOM EXCAVATING Address 16701 E VALLEYWAY AVE Phone: (509) 891-1232 VERADALE, WA 99037 Item Description SEWER CONNECTION PROCESSING FEE Units Unit Desc 1 NUNIBER OF 1 YORBLANK Operator CKF Printed 13y: CKF Permit Total Fees: Fcc Amount 385 00 315 00 $100.00 Print Date: 8/30/02 Project Number: 02007486 Inv: 1 Notes: Rppfi;ation THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date. 8/30/02 Page 2 of 2 Payment Summary: Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Sewer Connection Permit $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 construed 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: 8/30/02