1992, 02-28 Permit: 92001037 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WAS”INGTON 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 caQCl ,he provisions of any state or local law regulating construction, oras a warranty of conformance with the provisions of any state or local
laws regulating constructio
SIGNATURE OF////���� APPLICATION
OWNER OR AGENT 4Mit.V/ /'L! l .t..A Q�a�da DATE
PROJECT NUMBER= 22001037 ISSUED PERMIT
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SITE STREET=
lx -it PERMIT INFORMA
BLAKE RD
ADDRESS`- SPOKANE WA 992.16
'JEER CONNECTION
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PERMIT I.
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PLAT NAME
LOT
F''A
:1I: DWELLINGS
..JiJi:(r:; iii:IdS r DANNY
S T'.i:1MBERL.ANE: RD
VEPADr`)i..1:. WA 99037
CONTACT NAME= DANNY ..JiERGENS
RANGE
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DATE* 02/28/
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PHONE E:: NUMBE::R= os' 924 .....i'ic
BUILDING SETBACKS: ET.ANT= NA LEFT NA RIGHT= Wei REAR= NA
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CONTRACTOR=
ITEM
E'ROC:E
SEWER
OWNER
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TOTA
PERMIT TYPE
SEWER PERMIT
PROC:E, E D
PRINTED
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1EC.TION
SEWER.. ... .. ... . .
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QUAiNTTT
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R/92
IE
L.ARSOON
: (='1C'-BU):L..7 INFORMATION
t.) i a.l...a. 1 a.c:.d l/l:.{'r11"i l rlE iJT (456-3604'.
RECIE:i P i;
1345
MINT
1
ri).l:)iV
50,00
PHONE=
FEE AMOUNT
10„00
40,00
i. qG 3G 3r#P?p. ry; )i)1 P P
( X.....)i 31;
TOTAL 1=r;Ir, :
AMOUNT FAIT'
50,00
50..00
E1._TION AND POSITION OF SEWER
16 L
CALL
Tr
P:A A
3i' 3i' A 3i'
3E—P3 **H
OR APPLICANT 1:S TO ,:.'ELI
T1 ON
BURIED ]:EED C ABL..F:
E: YOU DIG i
ARE 10 BE CHECKED
Alt! CLEAR AND t.1PdOF S 1
CAL.1... FOR ]:N,:;'i:''ECT7:Ctf, r
24 HOUR NOTICE Si I
456-3604
:***** THANK
PAY11{F.PJT. AMOUNT'
50,00
50 s C,C,
AMOUNT I Ul. NG
.00
.00
A'WAILA(3i E AT THE I:.i:ii.R.11--
CE
iJTY
ii::: AND c::c:l ll::.i:1:..
C. TO ANY OT'I+Ep
WATER LINES, Iii:(:::_(.,
TO POIN 1NECT EON TOINSURE
TO THE SEWER MAIN
TJ COVER x) :*)t*ia3t#il
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