2002, 06-10 Permit App: 02004642 Sewer Project Number: 02004642 Inv: 1 •Application Date: 6/10/02 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-LONGVIEW PUD Contact: HAYDEN HOMES
Address: 3327 N INDIAN TRAIL RD PMB#232
C-S-Z: SPOKANE,WA 99208
Setbacks:Front Left: Right: Rear: Phone: (509)000-0000
Group Name:
Site Information: Project Name:
Plat Key: 006266 Name: LONGVIEW PUD District: G
Parcel Number: 55192.2305 Block: 5 Lot: 2
SiteAddress: 17620 E 3RD LN Owner:Name: HAYDEN HOMES
GREENACRES, WA USA 9901 Address: 3327 N INDIAN TRAIL RD PMB#23
Location::GRE SPOKANE,WA 99208
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: .00 Acres Width: 0 Depth: 0 Right Of Way(ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Review cp j� $/0*Zi
Review by Utilities Release
GFS
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: JEF Printed By: JEF Print Date: 6/10/02
Project Number: 02004642 Inv: 1 Applicaii.an Date: 6/10/02 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: JEF Printed By: JEF Print Date: 6/10/02