1991, 10-02 Permit: 91004600 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
!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 a mm County to m000 /m processing. In addition / 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 specified
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 the 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 OR AGENT DATE
PROJECT NUMBER= 91004600 PERMIT DATE= 10/02/91
PAGE= 01
************************** PERMIT INFORMATION ****************************
SITE STREET= 9807 E ARCHERY AVE
ADDRESS= SPOKANE WA 99206
PERMIT USE— SEWER CONNECTION — DI%HMAN—MICA INTERCEPTOR PKG 42
*** SEE NOTE ***
PLATO= 002 367 PLAT NAME= EHERWOOD FORE%T (WHIEPERING PI
BLOCK= 3 LOT= 13 ZONE— %FR DI%TO= E
AREA= OOOOOOOO F/A= F WIDTH= DEPTH=
OF BLDG%= i 4 DWELLINGS= i WATER DI%T =
PARCEL0= 2054-13i3
OWNER= PURYEAR
STREET= 9807 E ARCHERY AVE
ADDRE%%=
SPOKANE WA 99206
CONTACT NAME= %IMP%ON %ANTITATION
PHONE=
PHONE NUMBER= 509 926 4781
BUILDING SETBACKS: FRONT= NA LEFT= NA RIGHT= HA REAR= NA
*************************** %EWER PERMIT *****************************
PHONE= 509 926 4781
CONTRACTOR= %IMPJON %ANITATION
%TREET= 78i BA
2 E LDWIN AVE
ADDRESS= SPOKANE WA 99212
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------ ------------ -------- ----------
PROCESSING FEE Y iO.00
SEWER CONNECTION i 40.00
******************************* PAYMENT %UMMARY ****************************
PAYMENT DATE RECEIPT:I:. PAYMENT AMOUNT
10/02/91 50.00
------------
TOTAL DUE= .00 TOTAL PAID= 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------ -------------
%EWER PERMIT 50.00 50 .O0 .00
-------------
------------
50.00 50.00 .00
PROCESSED BY: JULIE SHATTO
PRINTED BY: JULI[ %HATTO
SEWER STUB A%—BUILT INFORMATION I% AVAILABLE AT THE COUNTY
UTILITIE% DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND PG%ITION OF %EWEP %TUB PPIOR TO ANY OTHER
EXCAVATION
LINE%, ECT,
CTIGN TO INSURE
,EWER MAIN