2002, 05-21 Permit App: 02003919 Sewer Project Number: 02003919 Inv: e. pplication Date: 5/21/2002 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-MIDILOME EAST 3RD Contact: CLIFF SCHMITZ CONSTRUCTION
Address: 16520 E. SECRETARIAT
C - S -Z: VERADALE,WA 99037
Setbacks: Front Left: Right: Rear: Phone: (509)922-4297
Group Name:
Site Information: Project Name:
Plat Key: 006185 Name: MIDILOME EAST 3RD District: F
Parcel Number: 45341.1903 Block: 5 Lot: 3
SiteAddress: 13026 E 36TH AVE Owner: Name: CLIFF SCHMITZ CONSTRUCTIO
SPOKANE,WA USA 00000 Address: 16520 E SECRETARIAT LN
Location:: SPO VERADALE,WA 99037
Zoning: UR-3.5 Urban Residential 3.5
Water District: 999 UNKNOWN Hold: ❑
Area: 12,473 Sq Ft Width: 0 Depth: 0 Right Of Way(ft): 50
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review 5/1 I/07--
Review
c 7_Review by Utilities Released : : s . ilk • _
fr/rt1, 5 i elk).
Permits:
Sewer Connection Permit
Contractor: CLIFF SCHMITZ Firm: CLIFF SCHMITZ CONSTRUCTIO
Address: 16520 E SECRETARIAT Phone: (509)922-4297
VERADALE WA 99037
Item Description Units Unit Desc Fee Amount
SEWER CONNECTION 1 NUMBER OF $85.00
PROCESSING FEE I Y OR BLANK $15.00
Permit Total Fees: $100.00
Operator: RMB Printed By: RMB Print Date: 5/21/2002
Project Number: 02003919 Inv: I Application Date: 5/21/2002 Page 2 of 2
THIS IS NOT Al P1 RMIT
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: 5/21/2002