2001, 12-18 Permit App: 01002542 Sewer Project Number: 01002542 Inv: 1 Application Date: 12/18/01 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 Contact: EGBERT CONSTRUCTION INC
Address: PO BOX 326
C-S-Z: HAYDEN,ID 83835
Setbacks: Front Left: Right: Rear: Phone: (208)772-6043
Group Name:
Site Information: Project Name:
Plat Key: 001393 Name: KOKOMO TOWNSITE District: F
Parcel Number: 45283.5526 Block: 55 Lot: 16
SiteAddress: 11117 E 32ND AVE Owner:Name: COWAN,KAREN
SPOKANE,WA USA 00000 Address: 11121 E 32ND AVE
Location::SPO SPOKANE,WA 99206-5948
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: 7,096 Sq Ft Width: 50 Depth: 142 Right Of Way(ft): 60
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review •
Review by Utilities Released By:
KRROGERRIVEl2/3/Ol
Originally Released: 12/4/01 By: JDONIER
Permits:
Sewer Connection Permit
Contractor: EGBERT CONSTRUCTION INC Firm: RICK EGBERT CONSTRUCTION I
Address: PO BOX 326 Phone: (208)772-6043
HAYDEN,ID 83835
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: CKF Printed By: CKF Print Date: 4/16/01
Project Number: 01002542 Inv: 1 Application Date: 12/18/01 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 co9eepr f any other state or local laws or ordinances.
Signature: ; V :1141„ -tk—
•
Operator: CKF Printed By: CKF Print Date: 4/16/01