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2001, 08-27 Permit App: 01007275 Sewer Project Number: 01007275 Inv: 1 Application Date: 8/27/01 Page 1 of 1 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: SEWER CONNECTION-SOUTH PONDEROSA Contact: SHORT SEPTIC SERVICE INC Address: 3350 WILLIAMS RD E C-S-Z: ALMIRA WA 99103 Setbacks:Front Left: Right: Rear: Phone: (509)639-2393 Group Name: Site Information Project Name: Plat Key: 000000 Name: UNKNOWN District: F Parcel Number: 44042.0507 Block: Lot: SiteAddress: 4527 S SKIPWORTH RD Owner:Name: MCFARLANE,DAN SPOKANE,WA USA 99216 Address: 4527 S SKIPWORTH Location::SPO SPOKANE WA 99216 Zoning: UNKN Unknown Water District: Hold: ❑ Area: 0 Sq Ft Width: 0 Depth: 0 Right Of Way(ft): 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Information: oa,a,a vt,Ap .,. w epos ====“,spm=-- === w ).c- Department Review ENGINEER Road ObstructionReleased,By. Hold Reasons: 1 Permit Conditions: Q I S LZ)SSE Permits: ..._. , =. Sewer Connection Permit Contractor: SHORT SEPTIC SERVICE INC Firm: SHORT SEPTIC SERVICE INC Address: 3350 WILLIAMS RD E Phone: (509)639-2393 ALMIRA WA 99103 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 Payment Summary ._._ ��, r Pgra," . ..f.. _... .- Operator: JAS Printed By: JAS Print Date: 8/27/01 Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Sewer Connection Permit $100.00 $100.00 $0.00 $100.00 $100.00 $100.00 $0.00 $100.00