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2002, 01-31 Permit App: 02000622 Sewer Project Number: 02000622 Inv: 1 Application Date: 1/31/2002 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 -SPRINGFIELD 1ST @ Contact: LANZCE DOUGLASS INC AUTUMN CREST Address: 8510 N CRESTLINE C - S-Z: SPOKANE WA 99217-7718 Setbacks: Front Left: Right: Rear: Phone: (509)483-6532 Group Name: Site Information: Project Name: Plat Key: 006057 Name: SPRINGFIELD 1ST @ AUTUMN CREST District: F Parcel Number: 45261.5801 Block: 1 Lot: 1 SiteAddress: 1605 S ST.CHARLES RD Owner: Name: DOUGLASS,LANZCE G VERADALE,WA USA 99037 Address: 815 E ROSEWOOD ST Location::VER SPOKANE,WA 99208- Zoning: UR-3.5 Urban Residential 3.5 Water District: Hold: ❑ Area: 10,245 Sq Ft Width: 62 Depth: 105 Right Of Way(ft): 60 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Review Review by Utilities Released B'sr: Vt5 tr D2 Permits: Sewer Connection Permit Contractor: LANZCE G DOUGLASS,INC Firm: LANZCE G DOUGLASS,INC Address: 8510 N CRESTLINE Phone: (509)483-6532 SPOKANE,WA 99217 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 Operator: RMB Printed By: RMB Print Date: 1/31/2002 Project Number: 02000622 Inv: I Application Date: 1/31/2002 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: RMB Printed By: RMB Print Date: 1/31/2002