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2002, 05-20 Permit App: 02003869 Sewer r Project Number: 02003869 Inv: 1 Application Date: 5/20/02 Page 1 of 2 THIS IS NOT h PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: SEWER CONNECTION-EASTON Contact: COURCHAINE CONSTRUCTION Address: 19818 E SPRAGUE C-S-Z: GREENACRES,WA 99016 Setbacks: Front Left: Right: Rear: Phone: (509)924-5485 Group Name: Project Name: Site Information: Plat Key: 000000 Name: UNKNOWN District: F Parcel Number: 45162.1077 Block: Lot: SiteAddress: 816 N VAN MARTER RD Owner:Name: ESTINSON,JOE SPOKANE,WA 99206 Address: 816 N VAN MARTER RD Location::SPO SPOKANE,WA 99206 Zoning: UR-7 Urban Residential-7 Water District: Hold: ❑ Area: 0 Sq Ft Width: 0 Depth: 0 Right Of Way(ft): 0 Nbr of Bldgs: 1 Nbr of Dwellings: 2 Review Information: Review Road Obstruction Released By: oLS Permits: Sewer Connection Permit —— Contractor: COURCHAINE CONSTRUCTION Firm: COURCHAINE CONSTRUCTION Address: 19818 E SPRAGUE AVE Phone: (509)928-0846 GREENACRES,WA 99016 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: 5/20/02 Project Number: 02003869 Inv: 1 App'iC'ation Date: 5/20/02 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for caomnlencing 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: CKF Printed By: CKF Print Date: 5/20/02