2002, 05-01 Permit App: 02003195 Sewer Project Number: 02003195 Inv: 1 Application Date: 5/1/2002 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 Contact: HAYDEN ENTERPRISES
Address: 3327 W INDIAN TRAIL RD#232
C -S -Z: SPOKANE,WA 99208
Setbacks: Front Left: Right: Rear: Phone: (509) 994-4691
Group Name:
Site Information: Project Name:
Plat Key: 006266 Name: LONGVIEW PUD District: G
Parcel Number: 55192.0321 Block: 1 Lot: 4
SiteAddress: 17718 E 4TH AVE Owner: Name: HAYDEN ENTERPRISES
GREENACRES,WA USA 990 Address: 17626 E 2ND
Location:: GRE GREENACRES WA 99016
Zoning: UR-3.5 Urban Residential 3.5
Water District: 008 CONSOLIDATED IRRG#1 Hold: ❑
Area: 10,006 Sq Ft Width: 81 Depth: 122 Right Of Way(ft): 36
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information: . ...
Review
Review by Utilities Released By-
Permits:
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: RMB Printed By: RMB Print Date: 5/1/2002
Project Number: 02003195 Inv: 1 Application Date: 5/1/2002 Page 2 of 2
THIS IS NOTA 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: RMB Printed By: RMB Print Date: 5/1/2002