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2001, 09-27 Permit App: 01008435 Sewer Project Number: 01008435 Inv: 1 . _Application Date: 9/27/2001 Page 1 of 1 • THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: ................................................ ... Permit Use: SEWER CONNECTION-WELLESLEY MANOR Contact: VIETZKE EXCAVATING Address: 2011 S CRAIG RD C-S -Z: MEDICAL LAKE,WA.99022 Setbacks: Front Left: Right: Rear: Phone: (509)535-4814 Group Name: Site Information: Project Name: ................................................................................................................. . .. . Plat Key: 002846 Name: WELLESLEY MANOR ADD District: H Parcel Number: 46363.0310 Block: 1 Lot: 10 SiteAddress: 16008 E WABASH AVE Owner:Name: COUSINS,MICHAEL&ELIZABE SPOKANE,WA USA 00000 Address: 16008 E WABASH AVE Location::SPO SPOKANE,WA 99216-3503 Zoning: UR-3.5 Urban Residential 3.5 Water District: Hold: ❑ Area: 12,288 Sq Ft Width: 0 Depth: 0 Right Of Way(ft): 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review In orm ation: :. f Department Review ENGINEER Road Obstruction - -.o f Released By. �` r�� Hold Reasons: Permit Conditions: C1/45/30 4 5 '7 Perms ts: Sewer Connection Permit Contractor: VIETZKE EXCAVATING Firm: VIETZKE EXCAVATING Address: 2011 S CRAIG RD#1 Phone: (509)244-9607 MEDICAL LAKE,WA 99022 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 Pa men t umma : Operator: RMB Printed By: RMB Print Date: 9/27/2001 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 Notes .....::................::.::::......:..:_:...........................................................:...:.....;:..........;;:...;:.;:.;;:.;:::::<::<::<::::<:.....:::::_:::..........:..........:<:,<:::>:<:......::>::»......<:>:<:::,<: