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2002, 06-10 Permit App 02004632 SewerProject Number: 02004632 Inv: I ..ti Application Date: 6/10/02 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 - WELLESLEY MANOR 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: Site Information: Project Name: Plat Key: 002851 Name: WELLESLEY MANOR 4TH ADD District: H Parcel Number: 46363.0416 Block: Lot: SiteAddress: 4908 N ISENHART RD Owner: Name: GRANBOIS, BRUCE S. SPOKANE, WA 99216 Address: 4908 N ISENHART RD Location:: SPO SPOKANE, WA 99216 Zoning: UR-3.5 Urban Residential 3.5 Water District: Hold: ❑ Area: 0 Sq Ft Width: 75 Depth: 143 Right Of Way (ft): 50 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review In formation: Review Road Obstruction Permits: Released By: L L 13 Plumbing Permit Contractor: A+ DRAIN & SEWER SERVICE Firm: A+ CONSTRUCTION Address: 4923 N CONKLIN RD Phone: (509) 891-2280 SPOKANE, WA 99216 Item Description WATER PIPING - DWV PROCESSING FEE MINIMUM FEE ADJUSTMENT Units Unit Desc 1 NUMBER OF 1 Y OR BLANK 1 Select Permit Total Fees: Fee Amount $6.00 $25.00 $4.00 $35.00 Operator: CKF Printed By: CKF Print Date: 6/10/02 � Z Project Number: 02004632 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 6/10/02 Page 2 of 2 Sewer Connection Permit Contractor: A+ DRAIN & SEWER SERVICE Firm: A+ CONSTRUCTION Address: 4923 N CONKLIN RD Phone: (509) 891-2280 SPOKANE, WA 99216 Item Description Units Unit Desc Fee Amount SEWER CONNECTION 1 NUMBER OF $85.00 PROCESSING FEE 1 Y OR BLANK $15.00 Notes: Payment Summary: Permit Type Plumbing Permit Sewer Connection Permit Permit Total Fees: $100.00 Fee Amount Invoice Amount $35.00 $35.00 $100.00 $100.00 $135.00 $135.00 Amount Paid Amount Owing $0.00 $35.00 $0.00 $100.00 $0.00 $135.00 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: CKF Printed By: CKF Print Date: 6/10/02