2002, 05-14 Permit App: 02003676 SewerProject Number: 02003676
Inv: I - 7 . Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/14/02 Page 1 of 2
Project Information:
Permit Use: SEWER CONNECTION - SHELLEY LAKE Contact: DOUGLASS, LANZCE G INC
Address: 815 E ROSEWOOD
C - S - Z: SPOKANE, WA 99208
Setbacks: Front Left: Right: Rear: Phone: (509) 483-6532
Group Name:
Project Name:
Site Information:
Plat Key: 005862 Name: SHELLEY LAKE District: F
Parcel Number: 45242.1503 Block: 5
Lot: 3
SiteAddress: 16014 E 5TH LN Owner: Name: DOUGLASS, LANZCE G INC
VERADALE, WA USA 99037 Address: 815 E ROSEWOOD
Location:: VER SPOKANE, WA 99208
Zoning: UR -3.5 Urban Residential 3.5
Water District: 010 VERA Hold: ❑
Area: 7,606 Sq Ft
Width: 70 Depth: 108 Right Of Way (ft): 30
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Review by Utilities
Permits:
Released By:QT�f 2D1 (y2,
Sewer Connection Permit
Contractor: CANNON EXCAVATING INC Firm: CANNON EXCAVATING INC
Address: PO BOX 28778 Phone: (509) 467-6522
SPOKANE, WA 99228
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: JAS Printed By: JAS Print Date: 5/14/02
Project Number: 02003676 Inv: 1
Application
Date: 5/14/02 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes:
OCCUPANCY IS DENIED ON ALL LOTS UNTIL FURTHER NOTICE FROM DIV. OF UTILITIES
PER GENE REPP 3/26/97 CKF OK TO ISSUE SEWER PERMITS FOR: BLOCK 2 - LOTS 3
THROUGH 10 & 1, 2 BLOCK 3 - LOTS 1 THROUGH 7 BLOCK 4 - LOTS 1 THROUGH 4
BLOCK 5 - LOTS 2 THROUGH
6 & 19 BLOCK 6 - LOTS 1 THROUGH 10
Payment Summary:
Permit Type
Sewer Connection Permit
Fee Amount Invoice Amount Amount Paid Amount Owing
$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: JAS Printed By: JAS
Print Date: 5/14/02