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2002, 01-18 Permit App: 02000322 SewerProject Number: 02000322 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Proiect Information: Permit Use: DRYLINE SEWER CONNECTION / SP -1267-01 Date: 1/18/02 Page 1 of 2 Setbacks: Front Left: Right: Rear: Site Information: Plat Key: 006193 Name: SP -1267-01 Contact: ROGER GIDDINGS EXCAVATION Address: 11812 E. BIGELOW GULCH C - S - Z: SPOKANE, WA. 99217 Phone: (509) 922-5907 Group Name: Project Name: District: F Parcel Number: 45161.0638PTN Block: SiteAddress: 11718 E SINTO AVE SPOKANE, WA USA 99206 Location:: SPO Zoning: UR -3.5 Water District: Urban Residential 3.5 Area: 18,671 Sq Ft Width: 100 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Review Review by Utilities Lot: C Owner: Name: GORDON CURRY Address: 14313 E TRENT AVE SPOKANE, WA 99216 Hold: ❑ Depth: 186 Right Of Way (ft): 30 Permits: Ort-. To 1s.�t� ` D `c -L 1�-e Contractor: ROGER GIDDING Address: 11812 E BIGELOW GULCH RD SPOKANE, WA 99207 Item Description SEWER CONNECTION PROCESSING FEE Sewer Connection Permit Firm: ROGER GIDDINGS EXCAVATION Phone: (509) 922-5907 Units Unit Desc 1 NUMBER OF 1 Y OR BLANK Operator: CKF Printed By: CKF Permit Total Fees: Fee Amount $85.00 $15.00 $100.00 Print Date: 1/18/02 Project Number: 02000322 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 1/18/02 Page 2 of 2 Notes: ..h Payment Summary: Permit Type Sewer Connection Permit Fee Amount Invoice Amount Amount Paid Amount Owing $100.00 $100.00 $0.00 $100.00 $100.00 $100.00 $0.00 $100.00 Disclaimer: Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be complied with. Subsequent issuance of a permit shall not be contrued to be a permit for, or an approval of, any violation of any of the provisions of the code or of any other state or local laws or ordinances. Signature: Operator: CKF Printed By: CKF Print Date: 1/18/02