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2002, 06-07 Permit App: 02004569 Sewer x T Project Number: 02004569 Inv: 1 Application Date: 6/7/02 Page 1 of 2 THISTS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project In formation: Permit Use: SEWER CONNECTION-EASTON 1 Contact: HULTQUIST CONSTRUCTION Address: 14516 N FREYA C- S -Z: MEAD,WA 99021 Setbacks: Front Left: Right: Rear: Phone: (509)994-0080 Group Name: Site Information: Project Name: Plat Key: 001853 Name: OPPORTUNITY PLAT#2 District: H Parcel Number: 45084.0452 Block: Lot: SiteAddress: 1617 N UNIVERSITY RD Owner: Name: SPRAGUE,ALAN SPOKANE,WA 99206 Address: 1617 N UNIVERSITY RD Location::SPO SPOKANE,WA 99206 Zoning: UR3.5 Water District: Hold: ❑ Area: 32,640 Sq Ft Width: 136 Depth: 240 Right Of Way(ft): 50 Nbr of Bldgs: 3 Nbr of Dwellings: 1 Review Information: Review Road Obstruction Released BQ-63Th ICI I Permits: - — Sewer Connection Permit Contractor: HULTQUIST CONSTRUCTION Firm: HULTQUIST CONSTRUCTION Address: 14516 N FREYA RD Phone: (509)468-0216 MEAD,WA 99021 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: CKF Printed By: CKF Print Date: 6/7/02 Project Number: 02004569 Inv: 1 Application Date: 6/7/02 Page 2 of 2 THIS IS NOT A P .RMIT Penalties will be assessed for commencing work without a permit Notes: Payment Summary: Permit Type Fee Amount Invoice Amount Amount Paid Amount Owine 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: 6/7/02