2001, 12-21 Permit App: 01011002 Sewer Project Number: 01011002 Inv: 1 plication Date: 12/21/2001 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-MIDILOME EAST 2ND Contact: LEXINGTON HOMES INC
ADD Address: 12218 E NEZ PERCE LN
C- S -Z: SPOKANE,WA 99206
Setbacks: Front Left: Right: Rear: Phone: (509)924-1519
Group Name:
Site Information: Project Name:
...............................................................................................................
Plat Key: 006071 Name: MIDILOME EAST 2ND District: F
Parcel Number: 45342.1102 Block: 3 Lot: 2
SiteAddress: 12808 E 35TH AVE Owner:Name: LEXINGTON HOMES INC
SPOKANE,WA USA 00000 Address: 12218 E NEZ PERCE LN
Location::SPO SPOKANE,WA 99206
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: 0 Sq Ft Width: 80 Depth: 125 Right Of Way(ft): 50
Nbr of Bldgs: 1 Nbr of Dwellings: 1
ati
Review In orm on
Review
Review by Utilities Released By:
/op?
Sewer Connection Permit
Contractor: FOLSOM EXCAVATING INC Firm: FOLSOM EXCAVATING
Address: 16701 E VALLEYWAY AVE Phone: (509)891-1232
VERADALE,WA 99037
Item Description Units Unit Desc Fee Amount
SEWER CONNECTION I NUMBER OF $85.00
PROCESSING FEE 1 Y OR BLANK $15.00
Permit Total Fees: $100.00
Operator: MKC Printed By: MKC Print Date: 12/21/2001
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Project Number: 01011002 + Inv: 1 `Appl Cation Date: 12/21/2001 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: MKC Printed By: MKC Print Date: 12/21/2001