1991, 09-10 Permit App: 91005674 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
1 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 01 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, oras a warranty of conformance with the provisions of any state or local
laws regulating construction
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PROJECT NUMBER= 910056/4
DATE= 09/10!91 PAIGE=: 01
#k•3 *** THIS IS H r•I F'FFCMIT 3F3ir.***
COMMENCING WORK WITHOUT A FE .nl:t
PENPti._ T IE:S WIL..L.. BE ASSESSED FOR
SITE S t Ezi:ECT= 1623 S BLAKE: RI) PARCEL O= 27541-1024
ADDRESS= SPOKANE WA 99216
PERMIT USE= SEWER CONNECTION .... WOL..FCREST
3':*# SEE NOTE .k..k..
PLATt= 002752 PLAT NAME= VERA
BLOCK-= LOT= ZONE= A't:Il
AREA= (,0000000 1'/A= F WIDTH=
OE BLDGE= 0 DWELLINGS= 1 WATER DIST
DISTO=
DEPTH=
OWNER= JOHNSON I Hn1'JE::=.
STREET= 1623 S BLAKE RT;
ADDRESS= SPOKANE WA 99216
CONTACT NAME= LEONARD PHONE NUMBER= S(9 c/2,-., r.;r..:.,sy
nUILDINE SETBACKS: FRONT= NA LEFT= 1 T= Nf1 RIGHT= NA REAR= N1";
.)..-.31.. 11....:P..pit .}4 T. )t. )
.n.3i 3i ii )i 3i i': 3i 3t 3k•k 3i * SEWER PERMIT
C('..T-'.'1-RAf,"1(.ti:, N n S CONSTRUCTION
STREET= i'i 81 7 Iii: Vir"il...1...E::'tWAY AVE
ADDRITSS,T SPOKANE WA 992(:16
1i 3k 3': h:.* K 3•i k 3 3[.3' h:.k. i;..n..i':..)j .)I A n. rc kn k
PHONE= N1: = '509 926 8964
ITEM DESCRIPTION QUANTITY FEE:: AMOUNT
Y
10,00
40:.470
FEE AMOUNT AMOUNT PAID AMOUNT. OWING
50_00 ,00 50,00
50.00 .00 50,00
PROCESSING FEET:
SEWER CONNECTION
PERMIT TYPE
SEWER PERMIT
.JULIE SHATTO
JUL..]:ESHATTO
MFC ST(JLI AS—BUILT INFORMATION IS AVAILABLE AT THE COUNTY
LJTILI.TIES DEPARTMENT (456--3604)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER ,STAB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE B(JRIED CABLES, GAS PIPING, WATER LINES, EcT,
iCALL. BEFORE YOU D:FG (456-8000)
SEWER ,STUBS ARE TO BE: CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWERGirt IN
.A•.k..k..k..k.,h.A.lt.k. CALL FOR INSPECTION PRIOR TO COVER k'3i'#a'3i'3rriii'**
«3) 3t 1*) 3') 24 HOUR NOTICEREQUIRED 3f**xaf3ttnt.;c
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3:3e3-:33:*T: is i4 a:'P:'k'3':'k'3e'P:3i'3r Yl'P'3t')t31•)t ft i[f{'3i.3134343E THANK you )': ie 3e 3e ****i Eif3r3rieit3e3e3e 3e ie ie 3e dr 3rx�