1991, 10-01 Permit: 91002821 SewerSPOKANE 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 S x County to proceed with processing. In addition, 1 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=9iOO282i
ISSUED PERMIT DATE= 10/01/91 PAGE= 01
*************************** PERMIT INFORMATION ***************************
SITE STREET= 97O9 E ARCHERY AVE PARCELO= 20543-13i6
ADDRESS= SPOKANE WA 99206
PERMIT USE= %EWER CONNECTION - DI%HMAN MICA INTERCEPTOR PKG 42
*** SEE NOTE ***
PLATO=
BLOCK=
AREA=
OF BLDG%=
ADD
NER=
dEET=
E%%=
LETTENM
97O9 E
%POKANE
PLAT NAME= %HERWOOD FOREST (WHISPERING PI
LOT= 16 ZONE= %FR DI%TO=
F/A= F WIDTH= DEPTH= R/W=
0 DWELLING%= i WATER DIET =
R, PATRICK
.HERY AVE
99206
CONTACT NAME= RON %LOAN
BUILDING SETBACKS: FRONT= NA
*****************************
CONTRACTOR=
JTREET=
ADDRESS=
ITEM
PRO-
%E.4.11:1
ALWAYS ACTIVE
PO BOX i41562
SPOKANE WA 9921
DE%CRIPTION
FEE
�NECTION
PHONE=
PHONE NUMBER= 509 922 8500
LEFT= NA RIGHT= NA REAR= NA
4
PERMIT
******************************
PHONE= 509 922 8500
QUANTITY FEE AMOUNT
-------- ----------
iO.00
i 40.00
******************************* PAYMENT %UMMARY ****************************
PAYMENT DATF
iO/Oi/9i
TOTAL DUE=
PERMIT TYPE
-------------
%EWER PERMIT
PROCE%�
PRINl
BY: JULIE
BY: JULIE
RECEIPTO
7125
.00 TOTAL PAID=
AMOUNT PAID
-----------
50,00
-----------
50.00
FEE AMOUNT
-----------
50.00
-----------
50..00
%HATTO
%HATTO
SEWER %TUB A%-•
UTILITIE% DEPARTMENT (456-3604)
PAYMENT AMOUNT
50.00
------------
50,00
AMOUNT OWING
------------
.00
------------
.00
T INFORMATION I% AVAILABLE AT THE COUNTY
CONTRACTOR OR APPLICANT I% TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND PO%ITIGN OF JEWER %TUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, PIPING, WATER LINES, ECT,
CALL BEFORE YOU DIG (456- )00)
N ECTION TO IN%URE
HE %EWER MAIN
VER **********
**********
**********
***************************** THANK YOU *********************************