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2002, 05-20 Permit App: 02003868 Sewer Project Number: 02003868 Inv: 1 Application Date: 5/20/02 Page 1 of 2 THIS IS NOT A 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: Site Information: Project Name: Plat Key: 003152 Name: WYATT ADD District: F Parcel Number: 45162.2005 Block: Lot: SiteAddress: 1204 N VAN MARTER RD Owner:Name: GRIFFIT,MIKE SPOKANE,WA 99206 Address: 1206 N VAN MARTER RD Location::SPO SPOKANE,WA 99206 Zoning: UR-7 Urban Residential-7 Water District: Hold: ❑ Area: 0 Sq Ft Width: 90 Depth: 123 Right Of Way(ft): 0 Nbr of Bldgs: 1 Nbr of Dwellings: 2 Review Information: Review Road Obstruction Released By: # r . zo V j 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: 02003868 Inv: 1 Apt 1 Date: 5/20/02 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit A 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