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2001, 09-05 Permit App: 01007549 Sewer Project Number: 01007549 Inv: 1 Application Date: 9/5/01 Page 1 of 1 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: SEWER CONNECTION-FAIR ACRES Contact: GILLINGHAM SAND&GRAVEL Address: 9701 W CHAMPION LN C-S-Z: CHENEY WA 99004 Setbacks:Front Left: Right: Rear: Phone: (509)456-5527 Group Name: Site Information: Project Name: Plat Key: 000905 Name: FRUITLAND ADD. District: E Parcel Number: 45081.0135 Block: Lot: SiteAddress: 2511 N OBERLIN RD Owner:Name: GILLINGHAM,JACK SPOKANE,WA 99206 Address: 9701 W CHAMPION LN Location::SPO CHENEY WA 99004 Zoning: UNKN Unknown Water District: Hold: ❑ Area: 0 Sq Ft Width: 200 Depth: 100 Right Of Way(ft): 50 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Department Review UTILITIES Review by Utilities �� � � ,” ' Hold Reasons: Permit Conditions: Permits: Sewer Connection Permit Contractor: UNKNOWN Firm: UNKNOWN Address: UNKNOWN Phone: (000)000-0000 UNKNOWN,WA UNKNOWN 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 Payment Summary: Operator: JAS Printed By: JAS Print Date: 9/5/01 Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Sewer Connection Permit $100.00 $100.00 $0.00 $100.00 $100.00 $100.00 $0.00 $100.00 Notes: