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2002, 04-09 Permit App: 02002386 Sewer Project Number: 02002386 Inv: I Anrlication Date: 4/9/2002 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: SEWER CONNECTION-EASTON 1 Contact: ALLIED SEWER&BORING Address: 9317 S FREEMAN DR C - S -Z: MEDICAL LAKE,WA 99022 Setbacks: Front Left: Right: Rear: Phone: (509)924-8508 Group Name: Site Information: Project Name: Plat Key: CONY Name: CONVERTED CNTY DATA District: F Parcel Number: 45084.0474 Block: Lot: SiteAddress: 1809 N RAYMOND RD Owner: Name: WYLAND SPOKANE,WA 99206 Address: 1809 N RAYMOND RD Location::SPO SPOKANE,WA 99206 Zoning: UR-3.5 Urban Residential 3.5 Water District: Hold: ❑ Area: 8,704 Sq Ft Width: 68 Depth: 128 Right Of Way(ft): 0 Nbr of Bldgs: 0 Nbr of Dwellings: 1000 Review Information: Review Road Obstruction Released By: O 4-1 -9-0d... Sewer Connection Permit Contractor: ALLIED SEWER BORING Firm: ALLIED SEWER BORING COMPA Address: 9317 S FREEMAN DR Phone: (509)924-8508 MEDICAL LAKE,WA 99022 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: RMB Printed By: RMB Print Date: 4/9/2002 Project Number: 02002386 Inv: 1 Application Date: 4/9/2002 Page 2 of 2 THIS IS N0tA PERMIT Penalties will be assessed for commencing work without a permit Notes: Payment Summary: :: 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 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: RMB Printed By: RMB Print Date: 4/9/2002