2002, 05-28 Permit App: 02004122 SewerProject Number: 02004122 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/28/02 Page 1 of 2
Project Information:
Permit Use: SEWER CONNECTION - SOUTH PONDEROSA
Setbacks: Front
Site Information:
Left: Right: Rear:
Plat Key: 000875 Name: FOREST MEADOW ADD
Contact: INLAND EMPIRE EXCAVATION
Address: 10211 E. DRIFTWOOD
C - S - Z: SPOKANE, WA 99206
Phone: (509) 891-1586
Group Name:
Project Name:
District: E
Parcel Number: 45333.0205 Block:
SiteAddress: 4145 S SUNDOWN DR
SPOKANE, WA 99206
Location:: SPO
Zoning: UNKN Unknown
Water District:
Lot:
Owner: Name: LENTZ, TOM
Address: 4145 S SUNDOWN DR
SPOKANE, WA 99206
Hold: ❑
Area: 0 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 60
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Road Obstruction
Released 1
Sewer Connection Permit
Contractor: INLAND EMPIRE EXCAVATION
Address: 10211 E DRIFTWOOD
SPOKANE, WA 99206
Firm: INLAND EMPIRE EXCAVATION I
Phone: (509) 891-1586
Item Description Units Unit Desc
SEWER CONNECTION 1 NUMBER OF
PROCESSING FEE 1 Y OR BLANK
Operator: JAS Printed By: JAS
Fee Amount
$85.00
$15.00
Permit Total Fees: $100.00
Print Date: 5/28/02
Project Number: 02004122 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for' -tom nencing work without a permit
Date: 5/28/02 Page 2 of 2
Notes:,rFF
Payment Summary ,:;sflowr
Permit Type
Sewer Connection Permit
Fee Amount
$100.00
Invoice Amount
$100.00
Amount Paid
$0.00
Amount Owing
$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: JAS Printed By: JAS Print Date: 5/28/02