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2002, 01-30 Permit App: 02000555 Sewer
Project Number: 02000555 Inc: 1 Application Date: 1/30/02 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 SHELLEY LAKE Contact: LANZCE G DOUGLASS INC Address: 814 E ROSEWOOD AVE C-S-Z: SPOKANE,WA 99208 Setbacks: Front Left: Right: Rear: Phone: (509)483-6532 Group Name: Site Information: Project Name: Plat Key: 005862 Name: SHELLEY LAKE District: F Parcel Number: 45242.1711 Block: 7 Lot: 11 SiteAddress: 15914 E 6TH LN Owner: Name: LANZCE G DOUGLASS INC VERADALE,WA USA 99037 Address: 814 E ROSEWOOD AVE Location::VER SPOKANE,WA 99208 Zoning: UR-3.5 Urban Residential 3.5 Water District: Hold: ❑ Area: 7,700 Sq Ft Width: 70 Depth: 110 Right Of Way(ft): 30 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Review Review by Utilities Released 13y:etakk 12,4?...01/41eA0 k- a-02 Permits: 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: CKF Printed By: CKF Print Date: 1/30/02 Project Number: 02000555 Inv: 1 Application bate: 1/30/02 Page 2 of Z 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 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: CKF Printed By: CKF Print Date: 1/30/02 — JET 12 PE12N4 IT t2E1 F.4�E Tf2A1\11%/1 iTTAL LOCATIO'I S E.E 5E-L01/4 • 0 !rum Penults 0 Irrvestlpallun fee Issue peru+lIs . 0 Reinspection fee 0 Com1111ans 0 Other • COMMENTS (,14% _T© )ETz„ 712- TS • FC. _ SOV-L( 1 \-1Av E '55.Z. 4 5�t JLD Ca(?. 11 Z4/02 ,4,i T N ; Goo 04. . • 5a04 E .• 11N 15 20 5_ . Co T (0 0 0 `73 - • Lf1-1 ?. -120,A4 s Goey Via. -co