1991, 11-19 Permit: 91007977 Sewer ConnectionSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
I certify that I have examined this permit/application, state that the information contained in it and submitted by me or my agent to compile said permit/application is true
and correct, and authorize Spokane County to proceed with processing. In addition, I have read and understand the INSPECTION REQUIREMENTS/NOTICE
provisions included herein and agree to comply with same. All provisions of laws and ordinances governing this type of work will be complied with whether spec if ied
herein or not. I understand that the issuance of this permit/application and any subsequent inspection approvals or Certificates of Occupancy shall not be construed to
give authority to violate or cancel t e provisions of any state or local law regulating construction, or as a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER onmaswT/'—a~,�=� DATE
PROJECT NUMBER= 91007977
ISSUED PERMIT DATE= 11/19/91 PAGE= 01
**************************** psnmzT INFORMATION ****************************
SITE STREET= 2.207 S ADAMS RD PAecsL4~ 26541-1636
ADDRESS= VERADALE WA 99037
PERMIT USE= SEWER CONNECTION 91%-74
*** SEE NOTE ***
.e.
002748 PLAT NAME= vsmA
BLOCK= ZONE= AGRI DI%T4= F
AREA= F/A= F WIDTH= 150 DEPTH~ 530 R/W=
OF oLoGS~ 4 owsLLzmcr~ / WATER DIET =
OWNER= MATHEWS, ERNEST
STREET= 2207 E ADAMS RD
ADDRESS= VERADALE WA 99037
PHONE~ 509 926 6786
CONTACT NAME= A-i CONSTRUCTION PHONE NUMBER~ 509 922 4594
BUILDING SETBACKS: FRONT= NA LEFT= NA RIGHT= w* REAR~ w*
***************************** SEWER PERMIT ******************************
CONTRACTOR= UCTIOw
STREET= PO BOX 141557
ADDRESS= SPOKANE WA 99214
ITEM DESCRIPTION
PROCESSING FEE
SEWER CONNECTION
PHONE= 509 922 4594
QUANTITY FEE AMOUNT
-------- ----------
Y 10.00
40.00
******************************* pAYmswT sUmmAmY ****************************
pAvnswT DATE nECEIpT4 PAYMENT AmQuwT
11/19/91 8901 50.00
------------
TOTAL DUE= .Oo TOTAL PAID~ 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
------------- ------------- ------------
-------------
SEWER PERMIT 50.80 50.08 .00
------------- ------------ -------------
50 00 50.08 .80
PROCESSED BY JOHN LARSON
PRINTED BY: JOHN LARSON
SEWER STUB AS-BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-36045
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES, ECT.
CALL BEFORE YOU DIG (456-8000)
SEWER STUBS RE TO BE CHECKED TO CONNECTION TO INSURE
THAT THEY ARE CLEAR w %T o TO THE SEWER MAIN
********* CALL FOR INSPECTION PRIOn TO COVER **********
********* 2* HOUR NOTICE REQUIRED **********
********* 456-3604 **********
******************************** THANK YOU ********************************