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2002, 05-20 Permit App: 02003886 SewerProject Number: 02003886 Inv: 1 Application Date: 5/20/2002 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: ............ . Permit Use: SEWER CONNECTION - EASTON Setbacks: Front Left: Right: Rear: Site Information: .................... . Plat Key: 001838 Name: OPP.TR. 1-354 Contact: VISTA CONSTRUCTION & DEV Address: 3420 N. TSCHIRLEY RD C - S - Z: SPOKANE, WA 99216 Phone: (509) 926-2243 Group Name: Project Name: District: F Parcel Number: 45163.0426 Block: SiteAddress: 10805 E NIXON AVE SPOKANE, WA 99206 Location:: SPO Zoning: UR -3.5 Water District: Area: 0 Sq Ft Urban Residential 3.5 Lot: Owner: Name: BOHARA, MARY Address: 10805 E NIXON AVE SPOKANE, WA 99206 Hold: ❑ Width: 80 Depth: 160 Right Of Way (ft): 40 Nbr of Bldgs: 0 Nbr of Dwellings: 1 Review Information: Review Road Obstruction Permits: Released By. _.,„. „„,..„ 1fA aP C�2SC 3q2 Contractor: VISTA CONSTRUCTION & Address: 3420 N TSCHIRLEY RD #1 SPOKANE, WA 99216 Item Description SEWER CONNECTION PROCESSING FEE Sewer Connection Permit Finn: VISTA CONSTRUCTION & DEV Phone: (509) 926-2243 Units Unit Desc 1 NUMBER OF 1 Y OR BLANK Fee Amount $85.00 $15.00 Permit Total Fees: $100.00 Operator: RMB Printed By: RMB Print Date: 5/20/2002 Project Number: 02003886 Inv: 1 Application Date: 5/20/2002 THIS IS NOT AJPE;RMIT 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 Amount Paid Amount Owing $0.00 $100.00 $100.00 $100.00 $0.00 $100.00 Page 2 of 2 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: RMB Printed By: RMB Print Date: 5/20/2002