1997, 10-01 Permit App: 97007934 SewerPROJECT NUMBER= 97007934
PROJECT NUMBER= 97007934
APPLICATION
z APPLICATION
DATE= 10/01/97
DATE= 10/01/97
PAGE= 01
PAGE= 01
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 411 S SHELLEY LAKE LN PARCEL#= 45241
ADDRESS= GREENACRES WA 99016
PERMIT USE=
PLAT#=
BLOCK=
AREA=
# OF BLDGS=
OWNER=
STREET=
ADDRESS=
SEWER CONNECTION - SHELLEY LAKE PUD (97S-907)
005862
2
00000000
PLAT NAME=
LOT=
F/A=
DWELLINGS=
SHELLEY LAKE
2 ZONE= UR -12 DIST#=
F WIDTH= 76 DEPTH=
WATER DIST = VERA
ASVESTAS CONSTRUCTION
PO BOX 14244 AVE
SPOKANE WA 99214
CONTACT NAME= PAUL ASVESTAS
BUILDING SETBACKS: FRONT= NA
******************************
DEPARTMENT
UTILITIES
9027
d
lee'57
5
G
109 R/W=
PHONE= 509 924 1081
PHONE NUMBER= 509 924 10
LEFT= NA RIGHT= NA REAR= NA
REVIEW INFORMATION *****************************
REVIEW REQUIREMENT
CONNECTION AGREEMENT REQUIRED
COMMENTS: Q 7(9 1550J13 (3 Lk) IPLTjbiF(oAk7/
***************************** SEWER PERMIT
CONTRACTOR= ROBERT A. LONG
STREET= 9415 S SANDS RD
ADDRESS= VALLEYFORD WA 99036
ITEM DESCRIPTION
PROCESSING FEE
SEWER CONNECTION
PERMIT TYPE FEE AMOUNT
SEWER PERMIT
100.00
100.00
)o -z3-'7
SL:Wt31B2r L1Nrkt: tOcra, t R3
******************************
QUANTITY
PHONE= 509 924 4782
FEE AMOUNT
Y 15.00
1 85.00
AMOUNT PAID
AMOUNT OWING
.00 100.00
.00 100.00
42ect5"!rfie5
;;;;0/
/14mir
*******************************************************************************
* PLAT NOTE: TOPIC = CONDITIONS DEPT = BUILDING *
*******************************************************************************
OCCUPANCY IS DENIED ON ALL LOTS
DIV. OF UTILITIES PER GENE REPP
OK TO ISSUE SEWER PERMITS FOR:
BLOCK 2 - LOTS 3 THROUGH 10
BLOCK 3 - LOTS 1 THROUGH 7
UNTIL FURTHER NOTICE FROM
3/26/97 CKF
f0. IP21
PROJECT NUMBER= 97007934 APPLICATION
DATE= 10/01/97 PAGE= 02
*******************************************************************************
* PLAT NOTE: TOPIC = CONDITIONS DEPT = BUILDING
*******************************************************************************
BLOCK 4 - LOTS 1 THROUGH 4
BLOCK 5 - LOTS 2 THROUGH 6
BLOCK 6 - LOTS 1 THROUGH 10
PROCESSED BY: JULIE SHATTO
PRINTED BY: JULIE SHATTO
******************************** THANK YOU ************************************
Spokane County Division of Utilities
SEWER, CONNECTION PERMIT
APPLICATION FORM
PLEASE NOTE: This application form must be filled out accurately and in its entirety, and signed, or a permit will not be issued.
Also note that sewer permits are valid for 12 months from the date of issuance. No extensions will be granted.
PROJECT INFORMATION
Job address:
Owner's name:
ria 5 i1--5
City/State: d4) /4-62,Y
Phone:
Sod-q(;)—Y %
City: cpe
Zip:
Parcel number (ifknown):
First-time contractors or home -owners performing the installation must first contact the utilities department (in person or via phone
[456-3604]) before a permit can be issued.
Name of Utilities Division person contacted:
CONTRACTOR INFORMATION
Contractor (company name):
06L z;+' /ON (7 g-$6.644-0/all 0%n)
Business address:
City/State:
vava,rtyyz-tel
State contractor license number:,
c
Zip: Phone:
Contact Name:
dab /ONy
Phone: ??.0 gZ, 7 e
INTERIOR PLUMBING ALTERATIONS? (yes/no) circle one
Fill out the in ormation in the table below i a i licable**
Contractor (if different from above):
Business Address:
Phone:
City/State/Zip:
For, plunrbrng reversal fee rnforma:ion, see
FEE INFORMATION
Sewer Connection: Number of Buildings X (times) MOO (per bldg) = $
TOTAL FEE
• For a single-family residential unit, one permit is required;
• For a condominium, townhouse, duplex, triplex or fourplex with separate ownership (as determined by lot lines) separate
address and separate stub, one permit is required per address per stub;
• For a single building duplex, triplex or fourplex with single ownership, one permit is required
• Multiple buildings (apartments, industrial complexes) with single ownership, one permit required per building connecting to
the sewer.
(For situations not covered here, call the County Division of Utilities @ 456-3604)
APPLICANT SIGNATURE:
Date:
Return to:
Spokane County Division of Building & Planning
WW/est 1026 Broadway Avenue * Spokane, Washington 99260
PHONE: (509) 456-3675 * FAX: (509) 324-3198 * TDD: (509) 324-3166
Spokane County does not discriminate on the basis of d.sabdtty m the admssiou to, of treatment or employment in, its programs or activities. 10/14/te.\+.e.e\....p*