2002, 06-10 Permit App: 02004638 SewerProject Number: 02004638 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 6/10/2002 Page 1 of 2
Project Information:
............................................................... .
Permit Use: SEWER CONNECTION - WELLESLEY MANOR
Setbacks: Front
Left: Right: Rear:
Site Information:
......................................................... .
Plat Key: 002579 Name: SUNNYVALE ADDITION
Contact: COURCHAINE CONSTRUCTION
Address: 19818 E SPRAGUE
C - S - Z: GREENACRES, WA 99016
Phone: (509) 924-5485
Group Name:
Project Name:
District:
Parcel Number: 45011.1004
Block:
SiteAddress: 4712 N SUNNYVALE DR
SPOKANE, WA 99216
Location:: SPO
Zoning: SFR
Water District:
Area: 0 Sq Ft
Width: 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Lot:
Owner: Name: JENKINS, VERN
Address: 4712 N SUNNYVALE DR
SPOKANE, WA 99216
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Review
Road Obstruction
Permits:
.ccs
Sewer Connection Permit
Contractor: COURCHAINE CONSTRUCTION Firm: COURCHAINE CONSTRUCTION
Address: 19818 E SPRAGUE AVE Phone: (509) 928-0846
GREENACRES, WA 99016
Item Description
SEWER CONNECTION
PROCESSING FEE
Units Unit Desc
1 NUMBER OF
1 Y OR BLANK
Operator: RMB Printed By: RMB
Fee Amount
$85.00
$15.00
Permit Total Fees: $100.00
Print Date: 6/10/2002
Project Number: 02004638 Inv: 1
Application,, Date: 6/10/2002 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes: > :............................................
Payment Summary:
Permit Type
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: RMB Printed By: RMB
Print Date: 6/10/2002