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2002, 06-18 Permit App 02004897 SewerProject Number: 02004897 Inv: 1 Application Date: 6/18/2002 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 - SOUTH PONDEROSA Contact: ALLIED SEWER & BORING Address: 9317 S FREEMAN DR C - S - Z: MEDICAL LAKE, WA 99022 Setbacks: Front Phone: (509) 924-8508 Group Name: Project Name: Left: Right: Rear: Site Information: Plat Key: 001743 Name: MYRON ESTATES NO 8 District: F Parcel Number: 44042.2007 Block: SiteAddress: 10810 E FERRET DR SPOKANE, WA 99206 Location:: SPO Zoning: UNKN Unknown Water District: Area: 0 Sq Ft Width: 0 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: .. Lot: Owner: Name: Address: RITTER, BARB 10810 E FERRET DR SPOKANE, WA 99206 Hold: ❑ Depth: 0 Right Of Way (ft): 0 Review Road Obstruction S L (D1 Permits: Contractor: ALLIED SEWER BORING Address: 9317 S FREEMAN DR MEDICAL LAKE, WA 99022 Item Description SEWER CONNECTION PROCESSING FEE Sewer Connection Permit Firm: ALLIED SEWER BORING COMPA Phone: (509) 924-8508 Units Unit Desc 1 NUMBER OF 1 Y OR BLANK Permit Total Fees: Fee Amount $85,00 $15.00 $100.00 Operator: RMB Printed By: RMB Print Date: 6/18/2002 Project Number: 02004897 Inv: 1 Notes: 4 Application Date: 6/18/2002 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Payment Summary: Permit Type Sewer Connection Permit Fee Amount Invoice Amount Amount Paid Amount Owing $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: 6/18/2002