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2002, 06-18 Permit App: 02004898 Sewer Project Number: 02004898 Inv: 1 • Application Date: 6/18/2002 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-LONGVIEW PUD Contact: HAYDEN HOMES Address: 3327 W INDIAN TRAIL RD C -S-Z: SPOKANE,WA 99208 Setbacks: Front Left: Right: Rear: Phone: (509)362-3294 Group Name: Site Information: Project Name: Plat Key: 006175 Name: LONGVIEW District: G Parcel Number: 55192.2207 Block: 1 Lot: 7 SiteAddress: 17706 E 4TH AVE Owner: Name: HAYDEN HOMES GREENACRES,WA USA 990 Address: 3327 W INDIAN TRAIL RD Location::GRE SPOKANE,WA 99208 Zoning: UR-3.5 Urban Residential 3.5 Water District: Hold: ❑ Area: .00 Acres Width: 50 Depth: 126 Right Of Way(ft): 38 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: . Review Review by Utilities Released By- 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: DMD Printed By: DMD Print Date: 6/18/2002 Project Number: 0200-1898 Inv: 1 Application Date: 6/18/2002 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit 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: DMD Printed By: DMD Print Date: 6/18/2002