2002, 06-12 Permit App: 02004738 Sewer Project Number: 02004738 Inv: 1 Application Date: 6/12/02 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: GREENSTONE CONSTRUCTION,INC.
Address: 707 W 7TH AVE STE 320
C-S-Z: SPOKANE,WA 99204-2833
Setbacks: Front Left: Right: Rear: Phone: (509)458-5860
Group Name:
Site Information:
Project Name:
Plat Key: 006123 Name: DISHMAN COMMONS District: F
Parcel Number: 45291.2120 Block: 2 Lot: 10A
SiteAddress: 10127 E 17TH LN Owner:Name: GREENSTONE CONSTRUCTION,I
SPOKANE,WA USA 00000 Address: 707 W 7TH AVE STE 320
Location::SPO SPOKANE,WA 99204-2833
Zoning: UR-12 Urban Residential-12
Water District: Hold: ❑
Area: 4,535 Sq Ft Width: 42 Depth: 109 Right Of Way(ft): 32
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review In formation:
Review
•
Review by Utilities Released �, , -�-•� ‘01/* c
Permits: ....:
Sewer Connection Permit
Contractor: OWNER Firm: OWNER
Phone:
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: CKF Printed By: CKF Print Date: 6/12/02
Project Number: 02004738 Inv: 1 Application Date: 6/12/02 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: CKF Printed By: CKF Print Date: 6/12/02