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2002, 04-22 Permit App: 02002856 SewerProject Number: 02002856 Inv: I Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: SEWER CONNECTION - S PONDEROSA Contact: VISTA CONSTRUCTION & DEV Address: 3420 N. TSCHIRLEY RI) C - S - Z: SPOKANE, WA 99216 Setbacks: Front Left: Right: Rear: Phone: (509) 926-2243 Group Name: Site Information: Project Name. Date 4/22/02 Page 1 of 2 Plat Key: 003264 Name: SP -042 District: E Parcel Number 44042.9075 Block: Lot: SiteAddress: 11320 E PONDEROSA DR SPOKANE, WA 99206 Location:: SPO Zoning: AG Nater Distract Owner: Name: PLANT, PETE Addicss: 11320 E PONDEROSA 1)12 SPOKANE, WA 99206 Hold: ❑ Area: 0 Sq Ft Width: 0 Depth 0 Right Of \Vay (ft): 0 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Review Road Obstruction Released By: �� T �a—oa dries 9109 Permits: Server Connection Ptrwit Contractor: VISTA CONSTRUCTION & Firm: VISTA CONSTRUCTION & DEV Address 3420 N TSCHIRLEY RD #1 Phone: (509) 926-2243 SI'OKANE, WA 99216 Item Desci iption SEWER CONNECTION PROCESSING FEE Units Unit Dcsc 1 NUMBER OF 1 \' OR BLANK Operator: CKF Printed By: CKF Fee Amount $55.00 $15.00 Permit Total Fees: $100.00 Print Date: 4/22/02 Project Number: 02002856 Inv: I Notes: Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 4/22/02 Page 2 of 2 Payment Summary: Permit Type Sewer Connection Permit 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: CKF Printed By: CKF Print Dale: 4/22/02