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2002, 06-10 Permit App: 02004595 Sewer i Project Number: 02004595 Inv: 1 Application Date: 6/10/2002 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-SKYVIEW Contact: NORM'S EXCAVATING Address: P.O. BOX 574 C -S-Z: VERADALE,WA 99037 Setbacks: Front Left: Right: Rear: Phone: (509)928-0580 Group Name: Site Information: Project Name: Plat Key: 002392 Name: SKYVIEW ACRES ADD District: F Parcel Number: 45282.1022 Block: Lot: SiteAddress: 12117 E 27TH AVE Owner: Name: RUSSELL,HERB SPOKANE,WA 99206 Address: 12117 E 27TH AVE Location::SPO SPOKANE,WA 99206 Zoning: AGSUB Water District: Hold: ❑ Area: 0 Sq Ft Width: 0 Depth: 0 Right Of Way(ft): 0 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Review Road Obstruction Released By: , Sewer Connection Permit Contractor: NORM'S EXCAVATING Firm: NORM'S BOBCAT SERVICE Address: PO BOX 574 Phone: (509)928-0580 VERADALE,WA 99037 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: RMB Printed By: RMB Print Date: 6/10/2002 A Project Number: 02004595 Inv: / AppllcatiON Date: 6/10/2002 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: 6/10/2002