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2000, 11-28 Permit App: 00010784 Sewer Project Number: 00010784 Inv: 1 Application Date: 11/28/2000 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-PONDEROSA Contact: WALDORF CONSTRUCTION Address: PO BOX 840 C-S-Z: NEWMAN LAKE,WA 99025 Setbacks: Front Left: Right: Rear: Phone: (509)226-2055 Group Name: Site Information: Project Name: Plat Key: 001737 Name: MYRON ESTATES#2 District: F Parcel Number: 44042.0207 Block: Lot: SiteAddress: 4407 S SKIPWORTH ST Owner:Name: LOSELL,JOHN SPOKANE,WA 99206 Address: 4407 S SKIPWORTH ST Location::SPO SPOKANE,WA 99206 Zoning: SFR Water District: Hold: ❑ Area: 10,400 Sq Ft Width: 0 Depth: 0 Right Of Way(ft): 0 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: .,, � : . ,w Department Review ENGINEER Road Obstruction Released By: l ( `� l. Hold Reasons: Permit Conditions: CD cS Permits: , ob . Sewer Permit Contractor: WALDORF CONSTRUCTION Firm: RICHARD WALDORF/WALDORF Address: PO BOX 840 Phone: (509)226-0880 NEWMAN LAKE,WA 99025 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: CKF Printed By: CKF Print Date: 11/28/2000 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: „