21-059.00 Spokane County Environmental Svcs: Browns Park Improvements DocuSign Envelope ID:39C4430A-001D-46A9-B426-C4715E414E17 , j 0I
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`++ SEWER CONNECTION CHARGE AGREEMENT
F ,r ENVIRONMENTAL SERVICES DEPARTMENT
Spokane County Kevin R Cooke,P.E.,Environmental Services Director
LPYIPVNMLNSAL SLR\Ilf)
Date: 4.2.21 Development:Brown's Park Lot#: Block#:
Site Address: 3111 S.Pines Rd. Parcel#: 45273.9036
Owner: City of Spokane Valley Builder: Sewer Project: DEV
PRINT Name PRINT Name
❑Single Fam ❑Duplex ❑Multi-Fam ❑ADU/MHP 0 Comm'l Total/New ERUs 1 / 0
Comments: New ERU's based on water estimate of 750 CFM
Applicable ❑ Line Charge Component N/A @ $0 = $0.00
Charges: Q GFC Component Un-Subsidized 0 @ $4,630 = $0.00
❑ Credit(s) SCC/CCC- GFC- Credit = $0.00
TOTAL DUE: = $0.00
Payment Option Selected (Check One):
For payment option 1,builder may sign.For all other options,signature of property owner is required.
1. Total charges paid upon execution of charge agreement.
❑ 2. Bill in one lump sum the next billing cycle on
❑ 3. Payment plan according to table below: 6%annual interest applies. Billing to commence(select one):
❑ Next monthly billing cycle
❑ Upon occupancy or 1 year after connection completion,whichever occurs first.
(Excludes ADU's or properties with an active payment plan.)
SCC/CCC+GFC—select up to 240 months, GFC ONLY—select up to 120 months
#Months Existing Charges for Pre-Paid Charges to be Monthly
pBalance_ ERU Increase Amount Billed Rates
GFC
• Line Charge
E Bond
oo Interest
O.
TOTAL
Acknowledgement: The charges outlined above are based on the indicated use of the property. Future changes in property use or
increased water usage on commercial properties may require payment of additional Sewer Connection Charges. Sewer connection permits
are valid for one year from the date of issuance. Failure to complete the sewer connection within the one-year life of the permit will require
a new permit and new rates may apply. Late fees may apply if payments are not received timely.The principal balance may be paid in full
at any time without penalty. Partial payments of$500 or more will result in a reduction in monthly rates.Payment plans may not be revised
unless additional charges become due. Monthly sewer service fees are not included in the amounts shown in the table.
By signing below,I agree to the terms and cia►ges presented herein,and to disclose them in accordance with Washington State
disclosure laws / /
Owner(or Builder for option 1): �`an� C Date: .(/ j 31/ Z,
Signature
For office use only
Payment received from: Date:
Receipted by: Amount paid: Receipt#: os Check#:
4/6/2021
Prepared by: C. Depner Date: 4.2.21 Reviewed by: ` Date:
1026 West Broadway Avenue,4th Floor ^' Spokane,WA 99260-0430
PHONE: (509)477-3604 "' FAX: (509)477-4715 TDD: (509)477-7133
Spokane County,Environmental Services Department Charge Agreement,Effective 2/27/19