2002, 03-12 Permit App: 02001523 Sewer Project Number: 02001523 Inv: 1 Application Date: 3/12/2002 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 -RIDGEMONT EST 4TH Contact: LANZCE DOUGLASS INC
7TH ADD Address: 8510 N CRESTLINE
C -S -Z: SPOKANE WA 99217-7718
Setbacks: Front Left: Right: Rear: Phone: (509)483-6532
Group Name:
Site Information: Project Name:
Plat Key: 006093 Name: RIDGEMONT ESTATES NO. 4-7TH ADD District: F
Parcel Number: 45252.9096 Block: 1 Lot: 11
SiteAddress: 15524 E 21ST CT Owner: Name: LANZCE DOUGLASS
VERADALE,WA USA 99037 Address: 815 E ROSEWOOD
Location::VER SPOKANE,WA 99208
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: 10,175 Sq Ft Width: 80 Depth: 127 Right Of Way(ft): 50
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information: .
Review
Review by UtilitiesReleased By: Pak, � r d— lir' "tee
e CI+ 41,
Permits: .;;> l\
Sewer Connection Permit —
Contractor: CANNON EXCAVATING INC Firm: CANNON EXCAVATING INC
Address: PO BOX 28778 Phone: (509)467-6522
SPOKANE,WA 99228
Item Description Units Unit Desc Fee Amount
SEWER CONNECTION I NUMBER OF $85.00
PROCESSING FEE 1 Y OR BLANK $15.00
Permit Total Fees: $100.00
Operator: RMB Printed By: RMB Print Date: 3/12/2002
Project Number: 02001523 Inv: 1 Application Date: 3/12/2002 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: RMB Printed By: RMB Print Date: 3/12/2002
APR-8-02 10:20AM; PAGE 2/2
5094834966; _ " 1
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