2002, 04-19 Permit App: 02002729 Sewer Project Number: 02002729 Inv: 1 Application Date: 4/19/02 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-DISHMAN COMMONS Contact: BOB JACOBSON/NW REGIONAL FAC
Address: 525 E MISSION AVE
C-S-Z: SPOKANE WA 99202
Setbacks:Front Left: Right: Rear: Phone: (509)484-6733
Group Name:
Site Information: Project Name:
Plat Key: 006123 Name: DISHMAN COMMONS District: F
Parcel Number: 45291.1912 Block: 3 Lot: 9B
SiteAddress: 10016 E 17TH LN Owner: Name: NORTHWEST REGIONAL FACILI
SPOKANE,WA USA 99206 Address: 525 E MISSION
Location::SPO SPOKANE WA 99202
Zoning: UR-12 Urban Residential-12
Water District: 100 SPO CO WATER DIST#3A Hold: ❑
Area: 4,550 Sq Ft Width: 45 Depth: 100 Right Of Way(ft): 32
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
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Permits:
Sewer Connection Permit
Contractor: NORTHWEST REGIONAL Firm: NORTHWEST REGIONAL FACILI
Address: 525 E.MISSION AVE Phone: (509)484-6733
SPOKANE,WA 99202
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: JAS Printed By: JAS Print Date: 4/19/02
Project Number: 02002729 Inv: 1 Application Date: 4/19/02 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes:
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: JAS Printed By: JAS Print Date: 4/19/02