2002, 07-01 Permit App: 02005431 SewerProject Number: 02005431 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 7/1/02 Page 1 of 2
Project Information:
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Permit Use: SEWER CONNECTION - DRY LINE ONLY Contact: ALL SEASONS EXCAVATION
Address: POB 14978
C - S - Z: SPOKANE WA 99214
Setbacks: Front Left: Right: Rear: Phone: (509) 455-9285
Group Name:
Site Information: Project Name:
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Plat Key: 001866 Name: ORCHARD AVENUE ADD (TR.1-228)
Parcel Number: 35014.0124 Block: 63 Lot:
SiteAddress: 3405 N PARK RD
SPOKANE, WA USA 00000
Location:: SPO
Zoning: UR -3.5
Water District:
Urban Residential 3.5
Area: 11,475 Sq Ft Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
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District: H
Owner: Name: BANK OF FAIRFIELD
Address: PO BOX 267
FAIRFIELD, WA 99012-0267
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Review Information: offk ;„omeggewn..:�
Review
Review by Utilities Relea
Permits:
Contractor: ALL SEASONS EXCAVATION
Address: PO BOX 14978
SPOKANE, WA 99214
Sewer Connection Permit
Firm: ALL SEASONS EXCAVATION
Phone: (509) 922-4135
Item Description Units Unit Desc Fee Amount
SEWER CONNECTION 1 NUMBER OF $85.00
PROCESSING FEE 1 Y OR BLANK $15.00
Permit Total Fees: $100.00
Operator: JAS Printed By: Print Date:
Project Number: 02005431 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 7/1/02 Page 2 of 2
Payment Summary
Permit Type
Sewer Connection Permit
DIMMBENEN
Fee Amount Invoice Amount Amount Paid Amount Owing
$100.00 $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: JAS Printed By: Print Date: