2001, 11-05 Permit App: 01009815 Sewer Project Number: 01009815 Inv: 1 Application Date: 11/5/2001 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-GLENVIEW Contact: VIETZKE EXCAVATING
Address: 2011 S CRAIG RD
C-S -Z: MEDICAL LAKE,WA.99022
Setbacks: Front Left: Right: Rear: Phone: (509)244-9607
Group Name:
Site Information: Project Name:
..................................................................................................................................................................................
Plat Key: 001704 Name: MOUNTAIN VIEW 3RD ADD District: F
Parcel Number: 45281.1203 Block: Lot:
SiteAddress: 11708 E 18TH AVE Owner:Name: DOUGLAS,TODD D
SPOKANE,WA USA 99206 Address: 11708 E 18TH AVE
Location::SPO SPOKANE,WA 99206-5444
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: 17,250 Sq Ft Width: 0 Depth: 0 Right Of Way(ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review In ormation:
f
Review
Road Obstruction Released By:
5 83 7 5,
er s•
P mat .
Sewer Connection Permit
Contractor: VIETZKE EXCAVATING Firm: VIETZKE EXCAVATING
Address: 2011 S CRAIG RD#1 Phone: (509)244-9607
MEDICAL LAKE,WA 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
Operator: MKC Printed By: MKC Print Date: 11/5/2001
Project Number: 01009815 Inv: 1 Application Date: 11/5/2001 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes: ::
Pa ment Summa
V rV'
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 fmds 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: MKC Printed By: MKC Print Date: 11/5/2001