1991, 12-04 Permit: 91006330 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. 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= 91006330
**************************** PERMIT INFORMATION,****************************
PARCELa= 22541-0718 - -
ISSUED PERMIT
-DATE= 12/04/91 PAGE= 01
SITE STREET= 615.5 BLAKE RD
ADDRESS= SPOKANE WA 99216 . . ..
PERMIT USE= SEWER CONNECTION - ULID 903
*** SEE NOTE *** • - •
PLATO= 001669.- PLAT-NAME=-MOORE'S SURBURBAN HOMES ADD -
BLOCK= .3 - LOT= .6 ZONE= UR.3.5 DIST.=_ F
AREA= 00000000 F/A= F WIDTH= DEPTH=
IR/W= 50;
OF BLDGS= 1 ' -DWELLINGS= '1 WATER DIST =
OWNER= JENSEN - - PHONE=
STREET=:615 S BLAKE RD
ADDRESS= SPOKANEWA 99216
- CONTACT NAME= DONNA COURCHAINE PHONE NUMBER= 509 924 5485
BUILDING SETBACKS: FRONT= -NA LEFT= NA RIGHT= NA , REAR= NA --
*****************.************.SEWER PERMIT ********.**********************
CONTRACTOR= COURCHAINE CONSTRUCTION "'PHONE= 509 924 5485-'-
- STREET= 16402 E VALLEYWAY
ADDRESS= VERADAL_E_ WA 99037
ITEM DESCRIPTION QUANTITY FEE AMOUNT-,
PROCESSING FEE Y --- 10.00
SEWER CONNECTION 1 i 40.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE
12/04/91
'TOTAL DUE=
PERMIT TYPE
RECEIPT! -- PAYMENT AMOUNT-
.'f -
_9181 . ! 50.00.. ._
-.00 TOTAL 'PAID- . 50.00
-:FEE AMOUNT AMOUNT PAID AMOUNT OWING -
SEWER PERMIT 50.00
50.00
50.00 .00
50.00 .00
PROCESSED BY: JULIE SHATTO
PRINTED BY: DOMITROVICH, ROBIN. _.
—SEWER STUB:MS-BUILT INFORMATION IS AVAILABLE -AT THE COUNTY
UTILITIES DEPARTMENT (456-3604) ..
CONTRACTOR- OR APPLICANT' LS' TO FIEL_I) LOCATE ANI) 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 STUNS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN'"
********* CALL FOR INSPECTION PRIOR.TO:COVER-********** .
********* 24 HOUR NOTICE REQUIRED **********
*********_.. 456-3604 - - **********'
******************************** THANK YOU********************H************