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2001, 05-21 Permit App: 01003782 Sewer Project Number: 01003782 Inv: 1 Application Date: 5/21/01 Page 1 of I THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: SEWER CONNECTION-SOUTH PONDEROSA Contact: INLAND EMPIRE EXCAVATION Address: 10211 E.DRIFTWOOD C-S-Z: SPOKANE,WA 99206 Setbacks:Front Left: Right: Rear: Phone: (509)891-1586 Group Name: Site Information: Project Name: Plat Key: 001738 Name: MYRON ESTATES#2, 1ST ADD District: E Parcel Number: 44042.0503 Block: Lot: SiteAddress: 4505 S SKIPWORTH ST Owner:Name: TYSON,J.E. SPOKANE,WA 99206 Address: 4505 S SKIPWORTH ST Location::SPO SPOKANE,WA 99206 Zoning: SFR Water District: Hold: ❑ Area: 0 Sq Ft Width: 0 Depth: 0 Right Of Way(ft): 0 Nbr of Bldgs: 2 Nbr of Dwellings: 10 Review Information: ,ar Department Review ENGINEER Road Obstruction Released By L 5-Zi -Qj Hold Reasons: Permit Conditions: Li 1 `SL Lk. Sewer Permit -- - _-- Contractor: INLAND EMPIRE EXCAVATION Firm: INLAND EMPIRE EXCAVATION I Address: 10211 E DRIFTWOOD Phone: (509)891-1586 SPOKANE,WA 99206 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: Operator: RMB Printed By: RMB Print Date: 5/21/01 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: