2002, 07-16 Permit App: 02005965 SewerProject Number: 02005965 Inv: 1 Application Date: 7/16/02
THIS IS NOT .A PERMIT
Penalties will be assessed for commencing work without a permit
Page 1 of 2
Project Information:
Permit Use: SEWER CONNECTION - MIDILOME EAST 3RD Contact: CLIFF SCHMITZ CONSTRUCTION
Address: 16520 E SECRETARIAT
C - S - Z: VERADALE WA 99037
Setbacks: Front Left: Right: Rear: Phone: (509) 922-4297
Group Name:
Site Information: Project Name:
Plat Key: 006185 Name: MIDILOME EAST 3RD [)isti ict: F
Parcel Number: 45342.1705 Block: 3
Lot: 5
SiteAddress: 3525 S WOODLAWN DR Owner: Name: CLIFF SCHMITZ CONSTRUCTION
SPOKANE, WA USA 99206 Address: 16520 E SECRETARIAT
Location:: SPO VERADALE WA 99037
Zoning: UR -3.5 Urban Residential 3.5
Water District: 007 MODEL Hold: ❑
Area: .00 Acres Width: 109 Depth: 102 Right Of Way (ft): 60
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Review by Utilities
Permits:
Released By:
f=ew/
Sewer Connection Permit
Contractor: CLIFF SCHMITZ CONSTRUCTION Firm: CLIFF SCHMITZ CONSTRUCTION
Address: 16520 E SECRETARIAT Phone: (509) 922-4297
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
Operator: JAS Printed By: JAS
Permit Total Fees: $100.00
Print Date: 7/16/02
Project Number: 02005965 Inv: 1
Application
THIS IS NOTA PERMIT
Penalties will be assessed for commencing work without a permit
Date: 7/16/02 Page 2 of 2
Notes:
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.
Signature:
Operator: JAS Printed By: JAS
Print Date: 7/16/02