1991, 11-01 Permit: 91005757 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
I certify that 1 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, 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 perm it/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= 91005757
m}-ni
ISSUED PERMIT DATE= 11 i(,1 ;'i`1 PAGE= ti{
ii..ji.§: §: ii. h. y..h it iereiF;t.h. PERMIT INFORMATION
SITE STREET= 1 .. BLAKE RD
ADDRESS,, : SPOKANE. WA 99216
FIii:RIM:I:T USE .i'E:i:4iI_:r( CONNECTION -- Iu1.iI.F"C;RES_{
* Hit SEE
P PA Ft C.; E I...:i.:
9i iE ii di ii ii ii ii i'A - **
PLAT.= 0;0294) PLAT NAME== IWOLFCPEST ADD)
,.._
BLOCK, -2 LOT=; %t.iiVS..:::: SFR nSSTO=
AREA== 0000 0000 ti{;tj) P'/A= F WIDTH== DEPTH=
OE ?31f(:;5:= 1 :4 DWELLINGS= 1 WATER DIET
OWNER=
STREET= T=
ADDRESS=
TERRY
, BLAKE RD
fiNE WA 99216
CONTACT NAME= LEONARD
Y;,i,.i:i:i...Y>i.ivC. SETBACKS :
FRONT= NA LEFT:_: NA RIGHT== NA REAR-- NA
.. ... .. .
ve di� ir'n' �ie')t' 9i it hi ii iP 9i� ii� Pi tri �ii-u .a..h.* * ik ii iE .k..7..h:..ri..ri. SEWER PERMIT * * *ri di..li..h: ri..lp is .g. d(..ii.*'ii..ii..ii..ii' ir'hi
PHONE=
tr
R / W t;i
PHONE. NUMBER== `S _,Tv ?2A 8964
CONTRACTOR= Fi ' % ('(INSTRUCTION FliONi::.:':' .'.509 926
STREET= HEW/ 81 / i"; t/Al_.L..I'r:YWAY AVE
ADDRESS= SPOKANE' 61(i 99206
ITEM DESCRIPTION QUANTITY FEE AM1.11 i
PROCE ES:LNi= F'E::E: 10.00 .
SEWER ,ON T .LUN 40.00
i::(ii)i:urir:';+?iyi..ji..R. ii Rit a'it. ri..u. ri..ii..ii. it..ii..ii. it PAYMENT SUMMARY *Jir ri'i+;is:,i.ii..iiii**;tir:tt..n:.jt..i: ir: ;;. ;i x*isii*ik ii
ik
it' i¢ it'
PAYMENT 1T Di T I_..
11%01/:x1
TOTAL
PERMIT TYPE
SEWER PERMIT
DUE
RECEIPT PAYMENT AMOUNT
8264 50.00
.00 TOTAL. PAID= 50.00
FEE AMOUNT ANIC1UNT PAID AMOUNT OWIi'1C,
50.00 ;,00 . 00
....... .....
!40.00` 0 00
F-iiil('FSSED ht';`: ,Ii..li...IF.—RATIO
PRINTED .BY: JULIE SHATTO
SEWER STUB A:E' -il Ii:t...T INFORMATION IS iiLABLE:. AT THE COUNTY
Y
UTILITIES i:'c:.:'f+i;Iitl:NT (456-3604)
CONTRACTOR OR APPLICANT TS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCH;
C;AL1.. BF
SEWER ,
THAT THE;
Pi$r'Yi)i )'. '..) )t)'
1'191'* ii of ,iiia at
****Y:****
GAS PIPINGWAIEP LINES, ECT,
1 :a!!i ,t-8000) .
0 BE CHECKED PRIOR f0 (.ONNE_TLON TO IL URF
1..E.FiR AND i.1NI; BSTRI.IC T EDTO T'1"IiR: SEWER MAIN
. _. COVER il.i
FORFORINSPECTION PRIORPRIORtl.i (;[{ ot)';xa'iit,ii'atao-;t
HOUR I( NOl',11 ii1 Ii1Pi::;, *********k
4.,)6—..(>604 ' *m **RRA Il AA
p.*if:.li..jL.)i.:,i.:,i_yl.:/(.ii..ji..)itii:4ji.:,i.:,L.li..ji..jc.jL:,i. Pi..)i di 9i..Ri it. ii..)i'rt 'THANK
YOU ..i ir.jc j(..ji.:... :pj .jc .j{.
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