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2002, 08-26 Permit: 02007321 SewerProject Number: 02007321 Inv: 1 Application Date: 8/26/02 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for co—m-meacing work without a permit Proiect Information: Permit Use: SEWER CONNECTION - S PONDEROSA Contact: SHORT SEPTIC SERVICE INC Setbacks: Front Left: Right: Rear: Site Information: Plat Key: 001743 Name: MYRON ESTATES NO 8 Parcel Number: 44042.1812 Block: SiteAddress: 10807 E 48TH AVE SPOKANE, WA 99206 Location:: SPO Zoning: SFR Water District: Area: 0 Sq Ft Width: 0 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Review Road Obstruction Address: 3350 WILLIAMS RD E C - S - Z: ALMIRA WA 99103 Phone: (509) 639-2393 Group Name: Project Name: District: E Lot: Owner: Name: OVERBAY, SHANNON Address: 10807 E 48TH AVE SPOKANE, WA 99206 Hold: ❑ Depth: 0 Right Of Way (ft): 50 Permits:__. - - — — --- Sewer Connection Permit Contractor: SHORT SEPTIC SERVICE INC Firm: SHORT SEPTIC SERVICE INC Address: 3350 WILLIAMS RD E Phone: (509) 639-2393 ALMIRA WA 99103 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: 8/26/02 Project Number: 02007321 Inv: I Application Date: 8/26/02 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for -Cu, ;imencing 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 construed 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: CKF Printed By: CKF Print Date: 8/26/02