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2001, 05-31 Permit App: 01004150 SewerProject Number: 01004150 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 5/31/01 Page 1 of 2 Proiect Information: Permit Use: SEWER CONNECTION - SHELLEY LAKE 1ST ADD Setbacks: Front Site Information: Plat Key: 005947 Name: SHELLEY LAKE 1ST ADDITION Left: Right: Rear: ,.,.. AMRGdr% Contact: GEORGE H. WHITE INC. Address: PO BOX 52 C - S - Z: LIBERTY LAKE, WA 99019 Phone: (509) 994-2928 Group Name: Project Name: District: F Parcel Number: 45241.1819 Block: 1 Lot: 19 SiteAddress: 329 S SHELLEY LAKE LN Owner: Name: GEORGE H. WHITE INC. VERADALE, WA USA 99037 Address: PO BOX 52 Location:: VER LIBERTY LAKE, WA 99019 Zoning: UR -3.5 Water District: Area: 8,135 Sq Ft Nbr of Bldgs: 0 Urban Residential 3.5 Width: 0 Nbr of Dwellings: 0 Review Information: Hold: ❑ Depth: 0 Right Of Way (ft): 0 Denartment Review UTILITIES Review by Utilities Hold Reasons: Permit Conditions: ENGINEER Hold Reasons: Permit Conditions: Permits: OK PER G GREDVIG. KC Originally Released: 5/31/01 By: KCUMMIN Road Obstruction Contractor: Address: Sewer Permit NORTHWEST EXCAVATORS, INC Firm: NORTHWEST EXCAVATORS, INC 8307 N STANDARD Phone: (509) 466-7574 SPOKANE, WA 99208 Item Description SEWER CONNECTION PROCESSING FEE Units Unit Desc 1 NUMBER OF 1 Y OR BLANK Fee Amount $85.00 $15.00 Permit Total Fees: $100.00 Project Number: 010041 50 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Payment Summary: Operator: MKC Permit Type Sewer Permit Date: 5/31/01 Page 2 of 2 Printed By: MKC Print Date: 5/31/01 Fee Amount Invoice Amount Amount Paid Amount Owing $100.00 $100.00 $0.00 $100.00 $100.00 $100.00 Notes:,• DO NOT ISSUE SEWER PERMIT - OK TO ISSUE HOUSE PER ROGER 10/27/98 OK TO ISSUE SEWER PERMITS FOR: BLK 4-L 1 BLK5-L2,16,18 BLK 6 - L 1,3,5,6,9,10 BLK 7 - L 1,2 $0.00 $100.00