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2002, 02-11 Permit App: 02000809 SewerProject Number: 02000809 Inv: 1 Application Date: 2/11/02 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Proiect Information: Permit Use: SEWER CONNECTION - SOUTH PONDEROSA Setbacks: Front Left: Right: Rear: Site Information: Plat Key: 001741 Name: MYRON ESTATES #5 Parcel Number: 44042.1424 Block: SiteAddress: 11207 E 48TH AVE SPOKANE, WA 99206 Location:: SPO Zoning: UR -3.5 Urban Residential 3.5 Water District: Area: 0 Sq Ft Width: 90 Nbr of Bldgs: 0 Nbr of Dwellings: 1 Review Information: Review Road Obstruction 02 soL4 57 Contact: INLAND EMPIRE EXCAVATION Address: 10211 E. DRIFTWOOD C - S - Z: SPOKANE, WA 99206 Phone: (509) 891-1586 Group Name: Project Name: District: E Lot: Owner: Name: SEEFELDT, DOUG Address: 11207 E 48TH AVE SPOKANE, WA 99206 Hold: ❑ Depth: 142 Right Of Way (ft): 60 Released By: 1107. - D:• Permits:aram� - Sewer Connection Permit - Contractor: INLAND EMPIRE EXCAVATION Firm: INLAND EMPIRE EXCAVATION I Address: 10211 E DRIFTWOOD Phone: (509) 891-1586 SPOKANE, WA 99206 Item Description SEWER CONNECTION PROCESSING FEE Units Unit Desc Fee Amount I NUMBER OF $85.00 1 Y OR BLANK $15.00 Permit Total Fees: $100.00 Operator: CKF Printed By: CKF Print Date: 2/11/02 MW Project Number: 02000809 Inv: 1 Application 'ft' Date: 2/11/02 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: U Operator: CKF Printed By: CKF Print Date: 2/11/02