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2001, 05-17 Permit App 01003694 SewerProject Number: 01003694 Inv: 1 JIM Application Date: 5/17/01 Page 1 of 1 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: SEWER CONNECTION Contact: A+ DRAIN & SEWER SERVICE INC Address: 4923 N CONKLIN RD C - S - Z: SPOKANE, WA 99216 Setbacks: Front Left: Right: Rear: Phone: (509) 891-2280 Group Name: Project Name: Site Information: left .411,,N0141.1MOVFM41,4-• Plat Key: 002851 Name: WELLESLEY MANOR 4TH ADD Parcel Number: 46363.0411 Block: SiteAddress: 4907 N ISENHART RD SPOKANE, WA 99216 Location:: SPO Zoning: UR-3.5 Water District: Urban Residential 3.5 Lot: District: H Owner: Name: HANSEN, R.A. Address: 4907 N ISENHART RD SPOKANE, WA 99216 Hold: ❑ Area: 0 Sq Ft Width: 175 Depth: 100 Right Of Way (ft): 0 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Department ENGINEER Hold Reasons: Permit Conditions: Permits: Review Road Obstruction D S1R Z2D Released By: Sewer Perrnit Contractor: A+ DRAIN & SEWER SERVICE Firm: A+ CONSTRUCTION Address: 4923 N CONKLIN RD Phone: (509) 891-2280 SPOKANE, WA 99216 Item Description SEWER CONNECTION PROCESSING FEE Payment Summary: Operator: CKF Permit Type Sewer Permit Notes: Units Unit Desc Fee Amount 1 NUMBER OF $85.00 1 Y OR BLANK $15.00 Permit Total Fees: Printed By: CKF Print Date: $100.00 5/17/01 Fee Amount Invoice Amount Amount Paid Amount Owing $0.00 $100.00 $100.00 $100.00 $100.00 $100.00 $0.00 $100.00