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2002, 03-04 Permit App: 02001328 SewerProject Number: 02001328 4 Inv: 1 Application Date: 3/4/2002 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 - EMPIRE HEIGHTS Contact: VIETZKE EXCAVATING Address: 2011 S CRAIG RD C - S - Z: AIRWAY HEIGHTS, WA 99001 Setbacks: Front Left: Right: Rear: Phone: (509) 244-9607 Group Name: Site Information: Project Name: Plat Key: 000735 Name: EMPIRE HEIGHTS ADD District: D Parcel Number: 35241.2617 Block: Lot: SiteAddress: 6815 E 5T11 AVE SPOKANE, WA 99212 Location:: SPO Owner: Name: CHEN, KEVIN G. Address: 6815 E 5TH AVE SPOKANE, WA 99212 Zoning: UR -7 Urban Residential -7 Water District: Hold: ❑ Area: 0 Sq Ft Width: 125 Depth: 125 Right Of Way (ft): 60 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Review Road Obstruction Permits: Released By: oa 3S IbS Stover Connection Permit Contractor: VIETZKE EXCAVATING Firm: VIETZKE EXCAVATING Address: 2011 S CRAIG RD #1 Phone: (509) 244-9607 AIRWAY HEIGHTS, WA 99001 Item Description SEWER CONNECTION PROCESSING FEE Units Unit Desc 1 NUMBER OF 1 Y OR BLANK Operator: DMD Printed By: DMD Fee Amount $85.00 $15.00 Permit Total Fees: $100.00 Print Date: 3/4/2002 Project Number: 02001328 Inv: 1 Applicon THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit -4 Date: 3/4/2002 Page 2 of 2 Notes: Payment ent Summ arv::;;.;«.:: 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: 3/4/2002