2011, 07-22 Permit App 11003519 SewerProject Number: 11003519 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: SEWER CONNECTION
Setbacks: Front
Site Information:
Plat Key:
Left: Right: Rear:
Name: RANGE
Parcel Number: 45043.1704 Block: 1
SiteAddress: 11430 E COYOTE ROCK DR
Location:: CSV
Zoning: UNKN Unknown
Water District:
Area: 11,691 Sq Ft Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Review
Special Review
Permits:
Date: 7/22/2011 Page 1 of 2
Contact: INVEST NORTHWEST INC
Address: 3508 E WESLEY CT
C - S - Z: SPOKANE, WA 99202
Phone: (509) 999-5864
Group Name:
Project Name:
Lot: 4
Owner: Name:
Address:
District:
COYOTE ROCK LLC & NEIGHBO
608 NORTHWEST BLVD STE #103
COEUR D'ALENE, ID 83814
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Released By:
CONTRACTOR'S LICENSE HAS BEEN SUSPENDED.
Contractor: UNKNOWN
Address: UNKNOWN
UNKNOWN, WA UNKNOWN
Item Description
SEWER CONNECTION
PROCESSING FEE
Sewer Connection Permit
Firm: UNKNOWN
Phone: (000) 000-0000
Units Unit Desc
1 NUMBER OF
1 Y OR BLANK
Permit Total Fees:
Fee Amount
$125.00
$25.00
$150.00
Operator: K_C
Printed By: K_C
Print Date:
7/22/2011
Project Number: 11003519 Inv: 1
Notes:
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Payment Summary:
Permit Type
Sewer Connection Permit
Date: 7/22/2011 Page 2 of 2
Fee Amount Invoice Amount Amount Paid Amount Owing,
$150.00 $150.00 $0.00 $150.00
$150.00 $150.00 $0.00 $150.00
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: K_C Printed By: K_C
Print Date: 7/22/2011