2002, 05-17 Permit App: 02003804 Sewer Project Number: 02003804 Inv: 1 Application Date: 5/17/02 Page 1 of 2
THIS A NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: SEWER CONNECTION-MIDILOME EAST 3RD Contact: FOLSOM EXCAVATING
Address: 16701 E VALLEYWAY
C-S-Z: VERADALE WA 99037
Setbacks:Front Left: Right: Rear: Phone: (509)891-1232
Group Name:
Site Information: Project Name:
Plat Key: 006185 Name: MIDILOME EAST 3RD District: F
Parcel Number: 45341.1905 Block: 5 Lot: 5
SiteAddress: 13114 E 36TH AVE Owner:Name: LEXINGTON HOMES
SPOKANE,WA USA 99216 Address: PO BOX 141749
Location::SPO SPOKANE WA 99214
Zoning: UR-3.5 Urban Residential 3.5
Water District: 007 MODEL Hold: ❑
Area: .00 Acres Width: 0 Depth: 0 Right Of Way(ft): 50
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Review by Utilities Released By: Ailtt. � j71: 2___
Permits:
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 1 NUMBER OF $85.00
PROCESSING FEE 1 Y OR BLANK $15.00
Permit Total Fees: $100.00
Operator: JAS Printed By: JAS Print Date: 5/17/02
Project Number: 02003804 Inv: 1 Application Date: 5/17/02 Page 2 of 2
THIS IS No i A PERMIT
Penalties will be assessed for co.«.nezcing 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: JAS Printed By: JAS Print Date: 5/17/02