2002, 02-20 Permit App: 02001040 Swer Project Number: 02001040 Inv: 1 Application Date: 2/20/2002 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: ALLIED SEWER& BORING
Address: 9317 S FREEMAN DR
C - S -Z: MEDICAL LAKE,WA 99022
Setbacks: Front Left: Right: Rear: Phone: (509)924-8508
Group Name:
Project Name:
Site Information:
...... ............................ .............. ........................................................................ ............................ .............................................. .............
Plat Key: 002392 Name: SKYVIEW ACRES ADD District: F
Parcel Number: 45284.1429 Block: Lot:
SiteAddress: 11615 E 31ST AVE Owner: Name: LEWIS,JIM
SPOKANE,WA 99206 Address: 11615 E 31ST AVE
Location::SPO SPOKANE,WA 99206
Zoning: AGSUB
Water District: Hold: ❑
Area: 0 Sq Ft Width: 85 Depth: 150 Right Of Way(ft): 60
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Review -
Review by Utilities Released By: ,),O.
Review
Permits:
Sewer Connection Permit
Contractor: ALLIED SEWER BORING Firm: ALLIED SEWER BORING COMPA
Address: 9317 S FREEMAN DR Phone: (509)924-8508
MEDICAL LAKE,WA 99022
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: DMD Printed By: DMD Print Date: 2/20/2002
Project Number: 02001040 Inv: Z Application Date: 2/20/2002 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: DMD Printed By: DMD Print Date: 2/20/2002