1991, 10-01 Permit App: 91006330 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 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- 910063.30
APPLICATION DATE= .10A1/91 PAGE= 01
'***'x* THIS IS NOT A PERMIT yi•**-•*•*•
PENALTIES WILL BE ASSESSED FOR COMMENCING WCOR:K. WITHOUT A PERMIT
1I.TE:: STREET= 615 S BLAKE RD
ADDRESS= EDCJK.ANE L4A 995216
PERMIT U `E::== SEWER CONNECTION --- UL..:1:I; 903
• :• )r• SEE NOTE : • •
PARCEL4= 22541-0718
PL_AT4:= 001669 PLAT NAME=: MOORE' E EUREi(.)RT:{AN HOMEE ADD
/
BLOCK= - LOT= �?ZONE=(.II .. ry T3I T:H:::::
1._
AREA= 00 000000 1' A== F WIDTH= DE:F:'-I.1..1::::
OE PLDGE_:: ? 0 DWELLINGS= 1 WATER DIST ::::
OWNER= ,JE:NE1F.N
STREET= 61 r) BLAKE RD
ADDRESS= SPOKANE. WA 99216
PHONE=
17:
R /1.1.
i-i:i;' i AC T NAME= DONNA COURCF•IAI NE PHONE NUMBER ' 509 924 5405
BUILDING SETBACKS: FRONT= NA LEFT= Nt' RIGHT= NA REAR= NA
): 'F::f::1 'Y.• * it..k.*.Y: 'P.' . Y. P * n x * *:u..x..x..p:.k..h..h..p: * SEWER p E:. R rl .. ******K*********************
CONTRACTOR= COURCHAINE CONSTRUCTION
"TR E T- 16402 r:- V E;L..L_F:::YWAY
ADDRESS= \/ ERADAI...E WA 9903"
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FEE 'r 10.00
SEWER CONNECTION 1 40.00
PERMIT .TYPE FEE AMOUNT AMOUNT PAID )MOUNT 014:rNG
SEWER PERMIT 50.00 .00 50.00
PHONE= 509 924 5485
50.0() .00 50.00
PROCESSED BY: JULIE SH TTO
PRINTED BY: JULIE ,SHATTO
SEWER STUB AS—BUILT INFORMATION IS Ab'AILAEtI...E AT THE COUNTY
UTILITIES DEPARTMENT (456---3604)
CONTRACTOR OR APF'I...1:CANT IS TO FIELD LOCATE: AND CONFIRM THE
ELEVATION AND n POSIT ION OF SEWER „'TUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES, EC;T.
CALL BEFORE
YOIJ DIG (456-8000)
SEWER ST(JPS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE::
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
k'n''xx)c•'u''rt''N: CALL 1ClF: INSPECTION PRIOR COVER ********If:*
'4 HOUR NOTTCE RF!II r.R1_D : ;*)i')i••x••ri•)r*•)G
: •..,, ... 456-3604
) •ji: ) N ) } ) ) ) ) ) k tJl' *H*t !Tfit 1fiRYRR THANK T l Nt sJ*jr(RPE i*3!E * } R @ ?A11Pk 77iPN