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2002, 06-10 Permit App 02004599 Sewer
Project Number: 02004599 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: SEWER CONNECTION - EASTON 2 Contact: INLAND EXCAVATING & CONSTRUCTI Address: 3417 W OLSON RD C - S - Z: DEER PARK, WA 99006 Setbacks: Front Left: Right: Rear: Phone: (509) 276-8500 Group Name: Site Information: Project Name: Plat Key: 000986 Name: GILLINGHAM'S SUB District: F Parcel Number: 45162.1064 Block: 2 Lot: 13 SiteAddress: 11019 E BROADWAY AVE SPOKANE, WA USA 00000 Location:: SPO Zoning: UR-3.5 Water District: Urban Residential 3.5 Area: 18,043 Sq Ft Width: 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Information: Review Road Obstruction Permits: ©2S 11/4AV---47L4 Date: 6/10/02 Page 1 of 2 Owner: Name: CHRISTIANSON, MAURICE Address: 11019 E BROADWAY AVE SPOKANE, WA 99206-7204 Hold: ❑ Depth: 0 Right Of Way (ft): 0 Released By: Sewer Connection Permit Contractor: INLAND EXCAVATING & CONST Firm: INLAND EXCAVATING & CONST Address: 3417 W OLSON RD Phone: (509) 276-8500 DEER PARK, WA 99006 Item Description SEWER CONNECTION PROCESSING FEE Units Unit Desc Fee Amount 1 NUMBER OF $85.00 I Y OR BLANK $15.00 Permit Total Fees: $100.00 Operator: CKF Printed By: CKF Print Date: 6/10/02 Project Number: 02004599 Inv: I Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Notes: Payment Summary: Permit Type Sewer Connection Permit Fee Amount $100.00 $100.00 Invoice Amount $100.00 $100.00 Amount Paid $0.00 $0.00 Date: 6/10/02 Page 2 of 2 Amount Owing $100.00 $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: CKF Printed By: CKF Print Date: 6/10/02