2001, 12-04 Permit App: 01010610 SewerProject Number: 01010610 Inv: I tApplLication Date: 12/4/2001 Page I of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Proiect Information:
Permit Use: SEWER CONNECTION - CRESTVIEW ADD Contact: HAYDEN ENTERPRISES
Address: 2622 SW GLACIER PL #110
C - S - Z: REDMOND, OR 97756
Setbacks: Front Left: Right: Rear: Phone: (509) 216-1702
Group Name:
Site Information:......................................Project Name: ...........
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Plat Key: 006135 Name: CRESTVIEW ADDITION District: F
Parcel Number: 45263.5501 Block: Lot:
SiteAddress: 14304 E 25TH LN Owner: Name: HAYDEN ENTERPRISES
SPOKANE, WA USA 00000 Address: 2622 SW GLACIER PL #110
Location:: SPO REDMOND, OR 97756
Zoning: UR -7 Urban Residential -7
Water District: Hold: F
Area: 4,984 Sq Ft Width: 56 Depth: 89 Right Of Way (ft): 30
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
............................ ........ . X: X .............................
Review
Revi
Item Description
SEWER CONNECTION
PROCESSING FEE
Units Unit Desc Fee Amount
I NUMBER OF $85.00
1 Y OR BLANK $15.00
Permit Total Fees: $100.00
Operator: DMD Printed By: DMD Print Date: 12/4/2001
Project Number: 01010610 Inv: I Application Date: 12/4/2001 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes:. ...
Payment Summary: ry
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: 12/4/2001