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2001, 06-12 Permit App: 01004545 Sewer t Project Number: 01004545 Inv. 1 Date: 6/12/01 Page 1 of 1 THIS IS NOT A PERMIT Penalties will u e assessed for commencing work without a permit Project Information: Permit Use: SEWER CONNECTIO -APPLE VALLEY Contact: ALLIED SEWER&BORING Address: 9317 S FREEMAN DR C-S-Z: MEDICAL LAKE,WA 99022 Setbacks: Front Left: 'ight: Rear: Phone: (509)924-8508 Group Name: Site Information: Project Name: Plat Key: 999999 Name: • • GE District: F Parcel Number: 45213.9164 Block: Lot: SiteAddress: 11324 E 11T AVE Owner: Name: JULIAN,SCOTT SPOKANE, A 99206 Address: 11324 E 11TH AVE Location::SPO SPOKANE,WA 99206 Zoning: UR-3.5 rban Residential 3.5 Water District: Hold: ❑ Area: 0 Sq Ft Width: 114 Depth: 194 Right Of Way(ft): 50 Nbr of Bldgs: 1 .r of Dwellings: 1 Review Information: w�: m Department Revie ENGINEER Road 1 bstruction Released By: a/ Hold Reasons: Permit Conditions: Q � LAJ &g 41 Permits: r �., _ gym; Sewer Permit Contractor: ALLIED SEWER B t RING Firm: ALLIED SEWER BORING COMPA Address: 9317 S FREEMAN DR Phone: (509)924-8508 MEDICAL LAKE, A 99022 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 Payment Summary: �. Operator: RMB P •nted By: RMB Print Date: 6/12/01 Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Sewer Permit $100.00 $100.00 $0.00 $100.00 $100.00 $100.00 $0.00 $100.00 Notes: