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2002, 07-01 Permit App: 02005440 SewerProject Number: 02005440 Inv: 1 - Application THIS IS NOT A PERMIT Date: 7/1/02 Page 1 of 1 Penalties will be assessed for commencing work without a permit Project Information: Permit Use: SEWER CONNECTION - VALLEY VISTA Contact: INLAND EXCAVATING & CONSTRUCTI Address: 3417 W OLSON RD C - S - Z: DEER PARK, WA 99006 Setbacks: Front Left: Right: Rear: Phone: (509) 276-8500 Group Name: Site Information: Project Name: Plat Key: 000000 Name: UNKNOWN Parcel Number: 45174.0104 Block: Lot: SiteAddress: 710 N RAYMOND RD SPOKANE, WA USA 00000 Location:: SPO Zoning: UR -3.5 Water District: Urban Residential 3.5 District: F Owner: Name: DALKE, FRANK H Address: 710 N RAYMOND RD SPOKANE, WA 99206-3849 Hold: ❑ Area: .00 Acres Width: 0 Depth: 0 Right Of Way (ft): 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Information: ,.; Permits: Sewer Connection Permit Contractor: INLAND EXCAVATING & CONST Firm: INLAND EXCAVATING & CONST Address: 3417 W OLSON RD Phone: (509) 276-8500 DEER PARK, WA 99006 Item Description SEWER CONNECTION PROCESSING FEE Units Unit Desc 1 NUMBER OF 1 Y OR BLANK Notes: ," Payment Summary:��.. Permit Type Sewer Connection Permit Fee Amount $100.00 $100.00 Permit Total Fees: Invoice Amount $100.00 Fee Amount $85.00 $15.00 $100.00 Amount Paid Amount Owing $0.00 $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: 6.2.sAxics3( -j-oz Operator: JAS Printed By: Print Date: