1991, 11-01 Permit: 91005669 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 l 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 NUMBE't::= 91005669 ISSUED PERMIT
DATE= 11/01/91 PAr=E, =: ei
Hr**94##9r *9r PERMIT I .i'4 t -U `.. !-71 i_I .y dt 9i*dr iF 9t 4r 9t 9t 9t
SITE STREET= BLAKE RD
!'IDDRE:: SPOKAN :E WA 99206
PERMIT
USE== SEWER WER CONNiCTECN
999SEE NOTE
9i'9i'dE
I'' L.4 f =
BI... iO iCK:
i-1RE:A- '0 0000000
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a
PARCELS= 22544
140L..FCREE
FLAT NAME= BEN'S SUIT.,
LOT= 4 ZONE= A(.. IY.EStis
F%A=:: F WIDTH= t.;r:::P-h1..;:
DWELLINGS= 1 WATER DIST _..
OWNER= WALLACE
STREET.- ET. 1223 S BLAKE RD
ADDRESS= SPOKANE WA 99206
CONTACT NAME= LEONARD
PHONE=:
t
'o)9t 9t#9t9
Al
PHONE NUMBER= 509 926 8
BUILDING SETBACK S: FRONT:::: NA LEFT= NA RIGHT=: NA REAR= NA
Jt -)t -9t
voddrnindh9Ht ri: **Ap*alg*AhhikSEWER FErM_-
9@ 9t 9t 9i' di"k' )i' h ***N***** *.g..A.*.A..A..A..x.:,i. yi. yl.
CONTRACTOR=
STREET=-
A.DI) r ::'
CONSTRUCTION
E:. VAL..L..E:.YWAY AV—
ANE WA 992076
ITEM DESCRIPTION
I(.)N
PROCESSING !" E:.E:.
SEWER CONNECTION
i di 9i ii 9i 9t ii..u..a-ii ***9t h;')i.*******iQ..
PAYMENT DATE
11/01/91
TOTAL
PAYMENT
PHONE= SQY .:_..
QUANTITY fF'I::.I::. AMOUNT
'r i0,^5
�_; �
i 4l0
SU !'1Psi ClliY *9i :Q.. -x* *'**N**** ***'fl****
RECEIPTS
0264
^00 TitAL.. Fr'IID
PAYMENT AMOUNT
50.00
5ig.<Jii
TYPE FEE AMOUNT MOUNT PAID AMOUNT OLiINr;
I::. tel1::. is I C:. r'.1"i .! t 50.00 s'7 ., 0 td .00
50 00 50.00 ,00
P'ROCES'SED ret': _..11..IE SL!A'TT'O
PRINTED BY: JULIE SL!ATTO
SEWER ST'i_.Ij-: AS—BUILT INFORMATION IE AVAILABLE A_I. THE COUNTY
IiTIL_.I:-IIES DEP ARTMI NT '456-3r`...•iJ^ai
CONTRACTOR tC`,TOR nR APPLICANT 1:S TO FIELD LOCATE AND C'OiJFIRt•i iFil=:
_ T:LON AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
)TION
-OCATE bURIED CABLES, CTAS 1-'I:PI.NG, WATER LINES, EFT
i!...!._ BEFORE YOU D:E(, '' <3
STUBS ARE TO BE cI-ir.:.(.:kE.D F'E„TOR TO CONNECTION IN-VURE
THEY ARE CLEAR AND UN TEPi_if:: 1EE D TO TI1F SEWER 'i r'tiH.
l
*u:ii..)::.rv).n' f:f"tl..l.. FOR INSPECT 1.mN PRIOR TO COVER L:i1itii:J'isit.aifn)
et * * * 24 HOUR NOT!... .:.. REQUIRED **Y*******
t*** .<:}°6.._3,:<(:i.y )t Ui 9i it * * iii 96 * n;
';l 9i:)t'J'):';t*9i"x x----i'Jt"1'i')i:')e'**i'*Ti 'THANK, YOH .)i,- -)i-x .)i..)i, t'- *f*i')l- &*)E -(-x:- N:- **.*iii dtlt'h-)i.- /i. ')tN'Y: