1991, 09-18 Permit App: 91005816 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, oras a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PROJECT T NUMI;ER 91005616 APPLICATION
DATE= 09/18/91 PAGE= 01
i*i*i*i*i*-* THIS .LE NOT (A PERMIT *****ii'
PENALTIES WILL BE: ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE gSr,TFiEE::T-: 414 S BLAKE R
ADI)
ADDRESS= E, '• SPOKAN WA9 16
PERMIT USE= SEWER CONNECTION .... 1..►i...ID 903
ii:*r: SEE NOTE Ick*
PARCELO=
22541-0201
PLATO= 001051 PLAT NAME= GRAY ADD
BLOCK -
LOT= 1 ZONE= AG D I T K
AREA= 00000000 F:/A= F WIDTH -l= DEPTH=
OF BLDGS= I
DWELLINGS= 1 WATER DIST -
1 W= _..0
OWNER= 1<IL.i...IAN, MRS PHONE=
STREET::-: 4 1 =a E BLAKE R D
ADDRESS== SPOKANE WA 99216
CONTACT NAME= LEONARD PHONE NUMBER= 509 926 8964
BUILDING SETBACKS: ' rooT=.V 4` t tYT : NA RIGHT== NA REAR= Nr'
ll i* i* # i* * -K -K i* it• i* it i* -r.' K i* -K * -K i, * 'P• § 'P: -P.' •P' 'P: •K '10.' S E. W E: R F•' E R I 1 I T it i( il' iC- it -N: -li- i{ ii- -k' J: ik tk H iL' )k 'M1 $: -DF i4' SE Ml * h * 'll 'ji' 'R' 'A'
CONTRACTOR:::: I -I E CONSTRUCTION
ION
STREET- 11217 1::: VALLEYWAY AVE
ADDRESS= SPOKANE WA 99206
PHONE= 509 926 6964
ITEM DESCRIPTION QUANTITY FEE AMOUNT
F'ROCE:s E INc; FEE Y 10.00
EWER CONNECTION 1 40.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT 0W1NO
SEWER PERMIT 50. 00 ,00 50.00
0:0
50.00 AO 50.00
PROCESSED BY: ._il ii.. T E SHAT T O
PRINTED TE::D B : JULIE SHATT0i
SEWER STUB AS—BUILT INFORMATION 1:S AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604
CONTRACTOR (F i:jF APPLICANT TS TO FIELD L..C)CATE- AND CONFIRM T •i .E
ELEVATION f--ti_i I ; .t.t:)ry OF SEWER STUB PRIOR TO ANY OTHER
..'CA': A+i ION
TO LOCATE BURIED CABLES, GAS PIPING, WATER 1..].NES, ECT.
C.7tL_I. BEFORE DIG (456-6000)
.;I::I4E:Ft , T1_lT ' Ar...h_ To BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
ii••iC•iii*ii•ii..K.K••K CALL_ FOR INSPECTION PRIOR TO COVER *i::it***itx**
inti>.itit*-Ir*Y: 24 HOUR NOTICE REQUIRED ii*ii•ii•i*3*-Kk
456--3604 .;i..R*ii'h:**i*
i* it rr n it ir k i:k ra r * ir r **: * c * r'ii* THANK i O l • riik ii: ii xk K ;iiiii*ii{ i*