1999, 09-30 Permit App: 99009261 Sewer •
Project Number: 99009261 Inv: 1 Application Date: 9/30/99 Page 1 of 1
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
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Permit Use: SEWER CONNECTION-RIVERWALK 5TH Contact: CONDRON CONSTRUCTION
Address: 7205 W KENDICK RD
Setbacks:Front Left: Right: Rear: C-S -Z NINE MILE FALLS WA 99026
Phone: (509)325-4865
Site Information:
Plat Key: 005872 Name: RIVERWALK 5TH ADD District: G
Parcel Number: 55083.3802
SiteAddress: 18932 E RIVERWALK LN Owner:Name: CONDRON CONSTRUCTION,
GREENACRES,WA USA 99 Address: 7205 N KENDICK RD
Location::GRE NINE MILE FALLS,WA 99026
Zoning: UR-7 Urban Residential-7
Water District: 999 UNKNOWN Hold: ❑
Area: 6,600 Sq Ft Width: 60 Depth: 110 Right Of Way(ft): 35
Nbr of Bldgs: 1 Nbr of Dwellings: 1
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Department Review
UTILITIES Review by Utilities
Comments: l l CU 1c19
Perm ts:
Sewer Permit
Contractor: CONDRON CONSTRUCTION Firm: CRAIG CONDRON CONSTRUCTI
Address: 7205 W KENDICK AVE Phone: (509)325-4865
NINE MILE FALLS,WA 99026
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
Pa meetS •umma ........................
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Operator: RMB Printed By: RMB Print Date: 9/30/99
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Sewer Permit $100.00 $100.00 $0.00 $100.00
$100.00 $100.00 $0.00 $100.00
Notes:
OK TO ISSUE SEWER PERMITS PER BILLY 8/26/97
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S P O K A N E ? :1'1,7_," ;'t�{ F 4 F C O U N T Y
UTILITIES DIVISION A DIVISION OF THE PUBLIC WORKS DEPARTMENT
N.Bruce Rawls,P.E.,Utilities Director Gary Oberg, Director
GENERAL FACILITIES CHARGE (GFC)
PAYMENT OPTION SELECTION RECORD
PLEASE NOTE: Form must be filled out accurately and in its entirety, and signed, or a permit will not be issued.
,
C >� CF
Date: � ,-i2 I
I
M Plat Name: ���1Q`X V (3�� � ` Lot No(s): 2 Block No(s): Li
Av - 'Site Address(es): \g:P3-2- . g I v7.a\V--. Parcel No(s): `� %-�- 3 2--
Owner Name: C��'0s�V' `n\ Ccs,V\S \yc. OR Builder Name:
Payment Option Selected (Check One):
1. ( ) GFC payment received at issuance of Sewer Connection Permit by .
kj ivision of Utilities
2. ( ) GFC to be paid at closing.
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3. ( ) GFC payment in 24 equal monthly payments upon establishment of Sewer Billing Account.
Complete one of the following statements.
n a. Owner's Statement: I, , understand that I will be
J billed for the applicable GFC amount in 24 monthly installments. The monthly GFC installments will be
s added to my monthly sewer service charges.
P
b. Builder's Statement: I, , understand that because
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6 I am selecting this option for payment of the GFC, that the purchaser of the home will be responsible for
payment of the applicable GFC in 24 equal monthly installments. I agree to formally disclose to potential
buyers of the property that the GFC charges will be added to the monthly sewer service billings as soon as
billing comments.
iX k.% i '1\Ak k200\cf./
Owner's or Builder's Signature Date
Spokane County, GFC Payment Option Form
Division of Utilities Revised 9/13/99
1026 W. Broadway • Spokane, WA 99260-0180 • (509) 477-3604 FAX: (509) 477-4715 TDD: (509) 324-3166