2002, 06-21 Permit App: 02005059 SewerProject Number: 02005059 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 6/21/02 Page 1 of 2
Project Information:
Permit Use: SEWER CONNECTION - SOUTH PONDEROSA Contact: NORM'S EXCAVATING
Address: P.O. BOX 574
C - S - Z: VERADALE, WA 99037
Setbacks: Front Left: Right: Rear: Phone: (509) 928-0580
Group Name:
Site Information: Project Name:
Plat Key. 001743 Name MYRON ESTATES NO 8
Parcel Number: 44042.2025 13Iock:
District: D
Lot:
SiteAddress: 11217 E PONDEROSA DR Owner: Name: HARSHBERGER, STACY
SPOKANE. WA 99206 Address: 11217 E PONDEROSA DR
Location:: SPO SPOKANE, WA 99206
Zoning: UNKN
Water District:
Area: 0 Sq Ft
Unknown
Hold: ❑
Width: 160 Depth: 107 Right Of Way (ft). 60
Nbr of Bldgs: 0 Nbr of Dwellings: 1
Review Information:
Review
Road Obstruction
o a, -Sec 515
Permits:
Contractor: NORM'S EXCAVATING
Address: PO BOX 574
VERADALE, WA 99037
Item Description
SEWER CONNECTION
PROCESSING FEE
Released 13y:
-cal-o-�
Sewer Connection Permit
Firm: NORM'S BOBCAT SERVICE
Phone: (509) 928-0580
Units Unit Desc Fee Amount
I NUMBER OF $85.00
I 1' OR BLANK $15.00
Operator: CKF Printed 13y: CKF
Permit Total Fees: $100.00
Print Date: 6/21/02
Project Number. 02005059 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
a
Date: 6/21/02 Page 2 of 2
Notes:
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owme
Sewer Connection Permit $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.
Signatur e:
Operator CKF Printed By: CKF
Print Date: 6/21/02