2002, 05-08 Permit App: 02003459 SewerProject Number. 02003459 Inv: 1
•`" Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date. 5/8/2002 Page 1 of 2
Project Information:
Permit Use: SEWER CONNECTION - AUTUMN PLACE Contact: LANZCE DOUGLASS INC
Address8510 N CRESTLINE
C - S - Z: SPOKANE WA 99217-7718
Setbacks: Front Left. Right: Rear. Phone. (5119) 483-6532
Group Name:
.Site Information:Project Name
Plat Key: 999999 Name. RANGE District: F
Parcel Number: 45234.5501 Block 1
SiteAddress 1128 S NEWER CT
VERADALE, WA USA 991137
Location:: VER
Lot 1
Owner: Nance LANZCE DOUGLASS INC
Address: 815 E ROSEWOOD AVE
SPOKANE, WA 992118
Zoning: UR -3.5 Urban Residential 3.5
Water District: 999 UNKNOWN Hold ❑
Area: 11,514 Sq Ft Width- 85 Depth 138 Right Of Way (fl): 36
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Re;'icn' Information:
Roden.
Review by Utilities
Permits:
Relc,iscd Bv: ,_ k(), fr
Seiner Connection Permit
Contractor: LANZCE G DOUGLASS, INC Firm LANCZE G DOUGLASS, INC
Address 85111 N CRESTLINE Phone (5119) 483-6532
SPOKANE, WA 99217
Ilan Description
SEWER CONNECTION
PROCESSING FEE
Unus Unn Dcsc
I NUMBER OF
I
Y OR BLANK
Operator: RMB PrintedBy• RMB
Fee Amount
$85 00
515.00
Permit Total Fees: $100 00
Print Date. 5/8/2002
/I
Project Number: 02003459 Inv: I
Notes:
Application•
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/8/20112 Page 2 of 2
Papntent Summary: - .
Permit Type
Sewer Connection Permit
Fee Amount Invoice Amount
$100.00 $100.00
Amount Paid
$0.00
Amount Owing
$100.00
$I00.00 $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 he 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 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 Date: 5/8/2002