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2002, 07-29 Permit App: 02006400 SewerProject Number: 02006400 Inv: 1 App1iciation• THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 7/29/2002 Page 1 of 2 Project Information: Permit Use: SEWER CONNECTION - WALNUT Contact: BAILEY'S CONSTRUCTION Address: E. 3707 28TH C - S - Z: SPOKANE, WA 99223 Setbacks: Front Left: Right: Rear: Phone: (509) 532-0705 Group Name: Project Name: Site Information: ...............:...:............................ Plat Key: 001834 Name: OPP.TR 1-354 District: F Parcel Number: 45173.0529 Block: SiteAddress: 525 N WILLOW RD SPOKANE, WA USA 00000 Location:: SPO Lot: Owner: Name: HUGHES, JAMES W & CATHERIN Address: 525 N WILLOW RD SPOKANE, WA 99206 Zoning: UR -7 Urban Residential -7 Water District Hold: ❑ Area: 14,259 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Road Obstruction Mt.1f Released By: Sewer Connection Permit ................... ................... Contractor: BAILEY'S CONSTRUCTION Firm: BAILEY'S CONSTRUCTION Address: 3707 E 28TH AVE Phone: (509) 534-9605 SPOKANE, WA 99223 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: 7/29/2002 Project Number: 02006400 Inv: 1 Notes: Application Date: 7/29/2002 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit 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. Signatu re: Operator: RMB Printed By: RMB Print Date: 7/29/2002