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2002, 04-04 Permit App: 02002256 Sewer, Sewage EjectorProject Number: 02002256 Inv: / Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 4/4/02 Page I of 2 Project Information: Permit Use: SEWAGE EJECTOR/SEWER CONNECT/HUTCHINSON Setbacks: Front Left: Right: Rear: Site Information: Contact: VIETZKE EXCAVA'T'ING Address: 2011 S CRAIG RD C - S - Z. AIRWAY HEIGHTS, WA 99001 Phone: (509) 244-9607 Group Name: Project Name Plat Key: 999999 Name: RANGE District. F Parcel Number: 45074.9071 Block SiteAddress: 8519 E MISSION AVE SPOKANE, WA USA 99206 Location:: SPO Zoning UNKN Unknown Water District: Area: .29 Acres Width: 0 Nbr of 13Idgs: 0 Nbr of Dwellings: 0 Rehiew Information: L Lot: Owner: Name: BERTIS & WEIBER Address: 4204 E SPRAGUE AVE SPOKANE WA 99202 Hold. ❑ Depth: 0 Right Of \Vay (ft): 0 Review Road Obstruction o._S_r3J_t8S Permits: , Released By: Plumbing Permit Contractor: VIETZKE EXCAVATING Firni: VIETZKE EXCAVATING Address: 2011 S CRAIG RD #1 Phone: (509) 244-9607 AIRWAY HEIGHTS. WA 99001 Item Description SEWAGE EJECTOR PROCESSING FEE MINIMUM FEE ADJUSTMENT Units Unit Desc 1 NUMBER OF 1 Y OR BLANK I Select Operator: JAS Printed 13y: JAS Fee Amount $6.00 $25.00 $4 00 Permit Total Fees: 535.00 Print Date: 4/4/02 Project Number: 02002256 Inv: / Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 4/4/02 Contractor: VIETZKE EXCAVATING Address: 2011 S CRAIG RD #1 AIRWAY HEIGHTS, WA 99001 Item Description SEWER CONNECTION PROCESSING FEE Notes: Sewer Connection Permit Page 2 of 2 Firm: VIETZKE EXCAVATING Phone: (509) 244-9607 Units Unit Desc 1 NUMBER OF 1 Y OR BLANK Permit Total Fees: Fee Amount $85.00 $15.00 $100.00 Payment Summary: r Perniit Type Plumbing Perniit Sewer Connection Permit Fee Amount $35.00 $100.00 Invoice Amount $35.00 $100.00 $135.00 $135.00 Amount Paid $0.00 $0.00 Amount Owing $35.00 $100.00 $0.00 $135.00 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: JAS Printed By: JAS Print Dale: 4/4/02