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2002, 02-13 Permit App: 02000862 SewerProject Number: 02000862 Inv: 1 Application THIS ISNOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 2/13/2002 Page 1 of 2 Proiect Information: ............................... . Permit Use: SEWER CONNECTION - EASTON 2 Setbacks: Front Left: Right: Rear: Site Information: .............................................. Plat Key: 000636 Name: DOBRAVEC ADD. Contact: SPECIALTY DIRT WORKS Address: 482 DRAGON FLY DR C - S - Z: COEUR D'ALENE, ID 83815 Phone: (208) 676-0967 Group Name: Project Name: District: F Parcel Number: 45174.2801 Block: SiteAddress: 719 N UNIVERSITY RD SPOKANE, WA USA 00000 Location:: SPO Lot: Owner: Name: WITHERS, MARGARETTE Address: 719 N UNIVERSITY RD SPOKANE, WA 99206-5051 Zoning: UR -3.5 Urban Residential 3.5 Water District: Hold: ❑ Area: .00 Acres Width: 0 Depth: 0 Right Of Way (ft): 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Review Permits: Released• ................... Sewer Connection Permit Contrac/,r UNKNOWN Firm: UNKNOWN Addre s: UNKNOWN Phone: (000) 000-0000 UNKNOWN, WA OWN 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: 2/13/2002 Project Number: 02000862 Inv: 1 Application THIS IS NOT i PERMIT Penalties will be assessed for commencing work without a permit Date: 2/13/2002 Page 2 of 2 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: 2/13/2002