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2002, 04-17 Permit App: 02002652 Sewer Project Number: 02002652 Inv: 1 -Application Date: 4/17/2002 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-SP-965-94 Contact: JTS DEVELOPMENT Address: 4029 S TERRA VERDE DR C - S -Z: VERADALE,WA 99037 Setbacks: Front Left: Right: Rear: Phone: (509)927-3879 Group Name: Site Information: Project Name: Plat Key: 005601 Name: SP-965-94 District: F Parcel Number: 45224.2253 Block: Lot: B SiteAddress: 13202 E 13TH AVE Owner: Name: JTS DEVELOPMENT INC SPOKANE,WA USA 00001) Address: 4029 S TERRA VERDE DR Location:: SPO VERADALE,WA 99037-9124 Zoning: UR-3.5 Urban Residential 3.5 Water District: Hold: ❑ Area: 14,212 Sq Ft Width: 100 Depth: 142 Right Of Way(ft): 50 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Review /-/ i' /v 7-- Review by Utilities Released Permits: Sewer Connection Permit Contractor: JTS DEVELOPMENT INC Firm: JTS DEV INC-JERRY STOLP Address: 4029 S TERRA VERDE DR Phone: (509)927-3879 VERADALE,WA 99037 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: RMB Printed By: RMB Print Date: 4/17/2002 r Project Number: 02002652 Inv: 1 Application Date: 4/17/2002 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Notes: WATER DISTRICT APPROVAL REQUIRED 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: RMB Printed By: RMB Print Date: 4/17/2002