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2002, 01-18 Permit App: 02000323 SewerProject Number: 02000323 Inv: 1 Application Date: 1/18/02 Page 1 of 2 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 Contact: ROGER GIDDINGS EXCAVATION Address: 11812 E. BIGELOW GULCH C - S - Z: SPOKANE, WA. 99217 Setbacks: Front Left: Right: Rear: Phone: (509) 922-5907 Group Name: Project Name: Site Information: NEMEOMM MEMEMMO Plat Key: 006193 Name: SP -1267-01 District: F Parcel Number: 45161.0638PTN Block: SiteAddress: 11720 E SINTO AVE SPOKANE, WA USA 99206 Location:: SPO Zoning: UR -3.5 Urban Residential 3.5 Water District: 011 MODERN Area: 17,723 Sq Ft Width: 0 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Lot: D Owner: Name: CURRY, GORDON Address: 14313 E TRENT SPOKANE, WA 99216 Hold: ❑ Depth: 0 Right Of Way (ft): 0 Review Review by Utilities Permits: 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 $100.00 Print Date: 1/18/02 Project Number: 02000323 Inv: 1 Application Date: 1/18/02 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Notes: .$>r Payment Summarya�a�x. ..,-.43wartmoommtmemonat 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 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