2002, 07-09 Permit App: 02005666 Sewer Project Number: 02005666 Inv: 1 Applica" 1 _, Date: 7/9/2002 Page 1 of 2
THIS S NOT A PERMIT
Penalties will be assessed for tImmencing work without a permit
Project Information:
Permit Use: SEWER CONNECTION-RIDGEMONT NORTH Contact: HARLEY C DOUGLASS INC
4TH-7TH ADD Address: 8510 N CRESTLINE ST
C -S -Z: SPOKANE,WA 99217-
Setbacks: Front Left: Right: Rear: Phone: (509)487-9792
Group Name:
Site Information: Project Name:
Plat Key: 006093 Name: RIDGEMONT ESTATES NO.4-7TH ADD District: F
Parcel Number: 45252.5214 Block: 1 Lot: 14
SiteAddress: 15608 E 21ST CT Owner: Name: HARLEY C DOUGLASS INC
VERADALE,WA USA 99037 Address: 8510 N CRESTLINE ST
Location::VER SPOKANE,WA 99217-
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: 12,543 Sq Ft Width: 80 Depth: 126 Right Of Way(ft): 50
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Review by Utilities Released By:
AJC 7?i ecAu,11r'cr
Permits:
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: DMD Printed By: DMD Print Date: 7/9/2002
Project Number: 02005666 Inv: 1 � *ifikpplication, Date: 7/9/2002 Page 2 of 2
THIS IS NOT A Fi,RMIT
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: DMD Printed By: DMD Print Date: 7/9/2002