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2002, 10-02 Permit App: 02008604 Sewer Project Number: 0200860.4 Inv: 1 Application Date: 10/2/2002 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-MIDILOME EAST 3RD Contact: LEXINGTON HOMES ADD Address: PO BOX 141749 C-S -Z: SPOKANE,WA 99214 Setbacks: Front Left: Right: Rear: Phone: (509)924-1519 Group Name: Site Information: Project Name: Plat Key: 006185 Name: MIDILOME EAST 3RD District: F Parcel Number: 45342.1702 Block: 3 Lot: 2 SiteAddress: 3507 S WOODLAWN DR Owner: Name: LEXINGTON HOMES SPOKANE,WA USA 00000 Address: PO BOX 141749 Location:: SPO SPOKANE,WA 99214 Zoning: UR-3.5 Urban Residential 3.5 Water District: Hold: ❑ Area: .00 Acres Width: 85 Depth: 122 Right Of Way(ft): 60 Nbr of Bldgs: 1 Nbr of Dwellings: 1 /" Review Information: Review f Review by Utilities Released By: /,,t • ' G' L1ti OVA C D1INF7G7 Sewer Connection Permit Contractor: FOLSOM EXCAVATING INC Firm: FOLSOM EXCAVATING Address: 16701 E VALLEYWAY AVE Phone: (509)891-1232 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: DMD Printed By: DMD Print Date: 10/2/2002 Project Number: 02008604 Inv: 1 Application Date: 10/2/2002 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed foroomxnencing 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 construed 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: DMD Printed By: DMD Print Date: 10/2/2002