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2002, 07-09 Permit App: 02005670 Sewer � .► r Project Number: 02005670 Inv: 1 Application Date: 7/9/2002 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 NORTH Contact: DOUGLASS,HARLEY C 4TH 7TH Address: 815 E ROSEWOOD C - S -Z: SPOKANE,WA 99208 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: 45252.9ft9fii Q z Block: 1 Lot: 2 SiteAddress: 15609 E 21ST CT Owner: Name: DOUGLASS,HARLEY C 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: 0 Sq Ft Width: 80 Depth: 105 Right Of Way(ft): 50 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Review Review by Utilities Released By: !y? 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 1 NUMBER OF $85.00 PROCESSING NEE I Y OR BLANK $15.00 Permit Total Fees: $100.00 Operator: DMD Printed By: DMD Print Date: 7/9/2002 • Project Number: 02005670 Inv: 1 Application Date: 7/9/2002 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencinwork 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. Sign a tu rc: Operator: DMD Printed By: DMD Print Date: 7/9/2002