2002, 05-10 Permit App: 02003585 SewerProject Number: 02003585 Inv: 1
J
Appiication
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/10/02 Page 1 of 2
Project Information:
Permit Use: SEWER CONNECTION - RIDGEMONT EST
NORTH 3RD ADD
Setbacks: Front
Site Information:
Plat Key: 005276 Name: RIDGEMONT ESTATES NORTH 3RD ADD District: F
Left: Right: Rear:
Contact: MADDEN, KEVIN M
Address: 12929 E SPRAGUE
C - S - Z: SPOKANE, WA 99206
Phone: (509) 927-7526
Group Name:
Project Name:
Parcel Number: 45252.3303 Block: 2
SiteAddress: 16110 E RENZ DR
VERADALE, WA USA 99037
Location:: VER
Zoning: UR -3.5 Urban Residential 3.5
Water District: 010 VERA
Area: 14,352 Sq Ft Width: 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Review by Utilities
Permits:
Lot: 3
Owner: Name: MADDEN, KEVIN M
Address: 12929 E SPRAGUE
SPOKANE, WA 99206
Hold: ❑
Depth: 0 Right Of Way (ft): 50
Released By: Ej LA (2.-1,1,41.5-,t-%
Contractor: OWNER
Item Description
SEWER CONNECTION
PROCESSING FEE
Sewer Connection Permit
Firm: OWNER
Phone:
Units Unit Desc
1 NUMBER OF
1 Y OR BLANK
Operator: JAS Printed By: JAS
Permit Total Fees:
Fee Amount
$85.00
$15.00
$100.00
Print Date: 5/10/02
Project Number: 02003585 Inv: 1
App,licatron
Date: 5/10/02 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes:
OK TO ISSUE SEWER PERMITS PER BILLY URHAUSEN 4/11/95 CKF
Payment Summary:
Permit Type
Sewer Connection Permit
u„n. x aE Y: -,baa.VNiltWk` M`_ *E ..;:.,ice==3:.
Fee Amount
$100.00
$100.00
Invoice Amount
$100.00
$100.00
Amount Paid
$0.00
$0.00
Amount Owing
$100.00
$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: JAS Printed By: JAS Print Date: 5/10/02
SEWER 7,PNASMITTAL
LOCATION 12-106G (-401QZ tOR.Ti-
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*Issue penults
❑ Conditions
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❑ Investigation fee
❑ Re -inspection fee
❑ Other
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