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2002, 04-30 Permit App: 02003145 Sewer Project Number: 02003145 Inv: 1 t lication Date: 4/30/2002 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: SEWER CONNECTION-EASTON Contact: ZUBER CONSTRUCTION Address: 26327 E MISSION C - S -Z: LIBERTY LAKE,WA 99019 Setbacks: Front Left: Right: Rear: Phone: (509)926-3777 Group Name: Site Information: Project Name: Plat Key: 000000 Name: UNKNOWN District: F Parcel Number: 45163.0185 Block: Lot: SiteAddress: 11223 E SPRINGFIELD AVE Owner: Name: LLOYD,JON E SPOKANE,WA USA 00000 Address: 13107 E 25TH AVE Location:: SPO SPOKANE,WA 99216-2516 Zoning: UR-3.5 Urban Residential 3.5 Water District: Hold: ❑ Area: 9,100 Sq Ft Width: 0 Depth: 0 Right Of Way(ft): 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Information: Review Road Obstruction Released By: //5 )b • o KJ30o_ Review by Utilities Released By: Permits: Sewer Connection Permit - Contractor: ZUBER CONSTRUCTION Firm: ZUBER CONSTRUCTION Address: 26327 E MISSION Phone: (509) 926-3777 LIBERTY LAKE,WA 99019 Item Description Units Unit Desc Fee Amount SEWER CONNECTION I NUMBER OF $85.00 PROCESSING FEE 1 Y OR BLANK $15.00 Permit Total Fees: $100.00 Operator: DMD Printed By: DMD Print Date: 4/30/2002 Project Number: 02003145 Inv: 1 Appilcation Date: 4/30/2002 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Notes: Payment Summary: ... 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: DMD Printed By: DMD Print Date: 4/30/2002