1991, 02-04 Permit App: 91000348 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 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 specified
herein or not. 1 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= 1000348 i)ATF= 02/04/91 PAGE= 01
APPLICATION
%**# # # *************K********** f• 1 F' ' I._ . - .. *******************************:k*
SITE
t I I�. STREET= 12910 E B l._ O :ti=t i4 u.' I:T E'' A R t.: F i... 4 — 27542-1546
ADDRESS= SPOKANE WA 99216
PERMIT USE= SEWER CONNECTION -- 8801
3*) * EEE NOTE **#
PLAT4= 001844 PLAT NAME= OPPORTUNITY TERRACE 3RD ADZ)
BLOCK= n LOT= r ZONE= AG,S'UB Di: STAN -- F='
x
AREA= 00000000 F'/A=:: F WIDTH DEPTH=
OF BLDGS= 0 DWELLINGS=
OWNER= HANSON, JOHN PHONE=
STREET= 12910 E E[I._CtSSEY AVE
ADDRESS= SPOKANE WA 99216
CONTACT NAME= DONNA COURCHAINE PHONE NUMBER= 509 924 5485
BUILDING :x .E •P_`iCK S: FRONT= NA LEFT= NA RIGHT= NA FtE.AR:::: NA
.***X)****•..3i•* • '#*-a'#***# P 3f'3t*• SEWER PERMIT *****************************.K
CONTRACTOR= COURCHAINE CONSTRUCTION
STREET= 16402 E 1t'ALL_EYWA Y
ADDRESS= VERADAL1= LJA 99037
PHONE= 509 924 5485
ITEM DESCRIPTION - QUANTITY FEE AMOUNT
PROCESSING FE::E: Y 10>00
SEWER CONNECTION i 40.:00
AMOUNT PAID
PERMIT TYPE
SEWER. PERMIT
FEE AMOUNT
5.0
,0050,00
AMOUNT OWING
-------------
50,00
PROCESSED BY: JULIE SHAT T O
PRINTED BY: JULIE 'l1ATTO
SEWER STUB AS—BUILT INFORMATION IS AVA:I:l..AFtI,,,E: AT THF COUNTY
UTILITIES DEPARTMENT (456-3..04)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THF
ELEVATION AND rOST T .FO`:l OF .SEWER •STUB PRIG TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES, FCT>
CALL BEFORE YOU DIG (456-8000)
SEWER STUBS ARE:: TO BE: CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE:: CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
#*****## CALL FOR. INSPECTION r•'F'.IC)R TO COVER #**#***#)
*#***** • _''.t. Hii1-IFt NOTICE REQUIRED *4,**•*xe;r -
u•*3i*ii3i3i*3t 456-3604 3i3i•3i3i• •3t•3i'#*#
4i•46•k•#4i-4t•*#m'3;#*#*3 :d:*#3f:**4F3i•*3E*3f'3i•##*# THANK YOU #* :i•*;2'•3i*•v:•3i•3i-3.3>:*j`.**3i###*3;•4k***ai•**3i:p.