2002, 06-26 Permit App: 02005223 SewerProject Number: 02005223 Inv: I
pplication
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 6/26/02 Page 1 of 2
Project Information:
Permit Use: SEWER CONNECTION - MII)ILOME EAST 3RD Contact: CLIFF SCHMITZ CONSTRUCTION
Address 16520 E SECRETARIAT
C - S - Z: VERADALE, WA 99037
Setbacks: Front Left: Right: Rear: Phone: (509) 999-7733
Group Name:
Site hrformationt Project Name:
Plat Key: 006185 Name: MIDILOME EAST 3RD
District: F
Parcel Number: 45342.1706 Block: 3
SiteAddress: 3526 S MCDONALD ST
SPOKANE, WA USA 00000
Location:: SPO
Zoning: UR -3.5
Water District
Urban Residential 3.5
Area: 12,163 Sq Ft Width: 0
Nbr of Bldgs 1 Nbr of Dwellings: 1
Lot: 6
Owner: Name: CLIFF SCHMITZ CONSTRUCTION
Address: 16520 E SECRETARIAT
VERADALE, WA 99037
Hold: ❑
Depth: 0 Right Of Way (ft): 50
Review Information •
Review
Plan Review
Permits:
OR kin—
Releasedvim-Z4-4- 1
GEC_ Fo gIY►
Seiner 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
I NUMBER OF
1 Y OR BLANK
Operator: CKF Printed I3y: CKF
Fee Amount
$85.00
$15.00
Permit Total Fees: $100.00
Print Date: 6/26/02
Project Number: 02005223 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 6/26/02 Page 2 of 2
Notes:
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Sewer Connection Permit $ I00.00 $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: 6/26/02