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2002, 02-27 Permit App: 02001189 SewerProject Number: 02001189 Inv: 1 Application Date: 2/27/2002 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Parcel Number: 45261.5904 Block: 2 Lot: 4 SiteAddress: 15207 E 17TH CT Owner: Name: DOUGLASS, LANZCE G VERADALE, WA USA 99037 Address: 815 E ROSEWOOD ST Location:: VER SPOKANE, WA 99208 - Zoning: UR -3.5 Urban Residential 3.5 Water District: Area: 11,064 Sq Ft Width: 0 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Hold: ❑ Depth: 0 Right Of Way (ft): 50 Permits: - Sewer Connection Permit Contractor: CANNON EXCAVATING INC Address: PO BOX 28778 SPOKANE, WA 99228 Item Description SEWER CONNECTION PROCESSING FEE Firm: CANNON EXCAVATING INC Phone: (509) 467-6522 Units Unit Desc Fee Amount I NUMBER OF $85.00 1 Y OR BLANK $15.00 Permit Total Fees: $100.00 Operator: RMB Printed By: RMB Print Date: 2/27/2002 Project Number: 02001189 Inv: 1 Application Date: 2/27/21102 Page 2 of 2 THIS IS NOT A PKRMIT Penalties will be assessed for commencing work without a permit ffh,%Fw� 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: 2/27/2002