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2002, 02-14 Permit App: 02000910 Sewer, Plumbing ReversalProject Number: 02000910 Inv. 1 Application Dale: 2/14/2002 Page 1 of 2 THIS 1S NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use SEWER CONNECTION - EASTON 1 & Contact: NORM'S EXCAVATING PLUMBING REVERSAL Address: P.O. BOX 574 C - 5 - Z: VERADALE, WA 99037 Setbacks Front Left: Right: Rear. Phone: (5119) 928-05811 Group Name: Site Informations Project Name: Plat Key: 001836 Name. OPP.TR. 1-354 District: F Parcel Number: 45084.0461 Block Lot: SiteAddress. 11161)5 E MISSION AVE Owner: Name HATFIELD, DON D SPOKANE, WA 99206 Address: 1116115 E MISSION AVE Location: SPO SPOKANE, WA 99206 Zoning- UNK Water District: Hold: ❑ Arca. 7,700 Sq Ft Width 70 Depth: 111) Right Of Way (ft): 11 Nbr of Bldgs. 0 Nbr of Dwellings: 11 Review Information : .. . ....... .. Resiew Road Obstruction Permits: Released Bv: - ... Plumbing Permit Contractor. BELKNAP PLUMBING Finn: BELKNAP PLUMBING Address: 3414 S. ADAMS RD Phone (5119) 921-5913 VERADALE, WA 99037 Item Description Units Unit Desc Fee Amount WATER PIPING - D\VV I NUMBER OF $n Oil PROCESSING FEE I Y OR BLANK $25 00 MINIMUM FEE ADJUSTMENT I Select 54.00 Operator: RMB Printed 13y RMB Permit Total Fees: 535 00 Print Date: 2/14/2002 Project Number: 02000910 Inv. 1 Application `.' Date:' 2/14/2002 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Sewer Connection Permit Contractor: NORM'S EXCAVATING Firm. NORM'S BOBCAT SERVICE Address: PO BOX 574 Phone. (51)9) 928-0580 VERADALE, WA 99037 Item Description SEWER CONNECTION PROCESSING FEE Notes: Payment Summary: Permit Tvpe Plumbing Permit Sewer Connection Permit Units Unit Desc 1 NUMBER OF I Y OR BLANK Permit Total Fees: Fee Amount Invoice Amount $35.00 $100.00 $35.00 $100.00 $135.00 $135.00 Fee Amount $85 01) $15 00 Amount Paid $0.00 $0.00 $100.00 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 intbrmation contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will he complied with. Subsequent issuance of a permit shall not he contrued to he 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. RMB Printed By: RMB Print Dale: 2/14/2002