2002, 06-21 Permit App: 02005058 Sewer p J �
Project Number: 02005058 Inv: 1 Application Date: 6/21/02 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-HUTCHINSON Contact: NORM'S EXCAVATING
Address: P.O.BOX 574
C-S-Z: VERADALE,WA 99037
Setbacks: Front Left: Right: Rear: Phone: (509)928-0580
Group Name:
Site Information: Project Name:
Plat Key: 000153 Name: BASCETTA'S ADD. District: F
Parcel Number: 45182.0523 Block: Lot:
SiteAddress: 1207 N VISTA RD Owner: Name: SCHULTZ,ELROY&EOLA
SPOKANE,WA 99212 Address: 1207 N VISTA RD
Location::SPO SPOKANE,WA 99212
Zoning: AGSUB
Water District: Hold: ❑
Area: 0 Sq Ft Width: 114 Depth: 130 Right Of Way(ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 1
Review Information:
Review
Road Obstruction
Released By: _et /
Permits:
Sewer Connection Permit
Contractor: NORM'S EXCAVATING Firm: NORM'S BOBCAT SERVICE
Address: PO BOX 574 Phone: (509)928-0580
VERADALE,WA 99037
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: 6/21/02
Project Number: 02005058 Inv: 1 Application Date: 6/21/02 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing 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: 6/21/02