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2001, 06-25 Permit App: 01005061 Sewer Project Number: 01005061 Int: 1 Application Date: 6/25/01 Page 1 of 1 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: SEWER CONNECTION-APPLE VALLEY Contact: COURCHAINE CONSTRUCTION Address: 19818 E SPRAGUE C-S-Z: GREENACRES,WA 99216 Setbacks: Front Left: Right: Rear: Phone: (509)924-5485 Group Name: Site Information: Project Name: Plat Key: 999999 Name: RANGE District: F Parcel Number: 45213.9096 Block: Lot: SiteAddress: 11310 E 12TH AVE Owner:Name: ZIMBELMAN,CODY SPOKANE,WA 99206 Address: 11310 E 12TH AVE Location::SPO SPOKANE,WA 99206 Zoning: UR-3.5 Urban Residential 3.5 Water District: Hold: ❑ Area: 0 Sq Ft Width: 82 Depth: 310 Right Of Way(ft): 40 Nbr of Bldgs: 2 Nbr of Dwellings: 1 Review Information: Department Review ENGINEER Road Obstruction Released By: 44 _�A " t Hold Reasons: i Permit Conditions: l_ I Permits: .. Sewer Permit Contractor: COURCHAINE CONSTRUCTION Firm: COURCHAINE CONSTRUCTION Address: 19818 E SPRAGUE AVE Phone: (509)928-0846 GREENACRES,WA 99016 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: CKF Printed By: CKF Print Date: 6/25/01 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: