1991, 07-29 Permit App: 91004555 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKA.IE, WACHINGTON 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, 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 1,1 .BER: 91004555
x; •r,' i *** THI TS NOT 3 .i ` !Vivi: **4***
PENALTIES WILL BE ASSESSED !" #.! p COMMENCING WRK a i T Lti i„ i I. ? '!r•"a PERMIT
------------
4 `.!..! i::.• STREET= 1519
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A
ADDRESS ,:.. R fit }? f••; ... !• u t 99 037
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BOLIVAR • D - P {..} t••,,••;
I^. i' {...:g: ::: 23543 —2M)2
PERMIT ,c,L EWER ONNECTION
3r. 3.. ,. ; -'• f . C . NOTE i't E *• * 3i•
OWNER=
STREET.-
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001447
1519GGOGOOGG
STORMS
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r: rre"t= F WIDTH=
WATER DIET
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!LC
FRONT- Cot ; LEFT= NA
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CONTRACTOR= TLC CONSTRUCTION
}:rig(:"b:,'•;:::: ,*•rtOit..f'tN;r-. WA 99246-
ITEM
9246-I_fEM DESCRIPTION
SEWER CONNECTION
PERMIT TYPE
SEWER PERMIT
PROCL':.iiSELr
PRINTED
FEE AMOUNT
50.00.
50.00
PERMIT
PHONE -
.t / •i :: 50
PHONE J LEa:3.7.,0-/ : :
6760
REAR -RIGHT NA
:t{• '• :Q' it: :n: 4k :t4 -n: ii -rt- $t::fF: •t?: •tt• .,,: :_`::k : 'tt- •A: 14• *P * :i:. •IF: -n: '!i: -K-
QUANTITY
.AMOUNT Oi.I}aT. :'•.'AID
.00
W.
rs
JUL..
•-i;.it...IE"3:•AS—BUILT
•1(? ?10 E:.[)ER STUB AS- BUIL # INFORMATION
UTILITIES DEPARTMENT (456-3604)
6 :9604)
PHONE- 509 5'27 6760
FFF AMOUNT
: i•}
40,00
AMOUNT fNT !:.i 1 '
. "j;
50,00
1 ,.. 4 V a T• t •r t t r.. AT
—HF !:: CO:,....,.,
CONTRACTOR OR APPLICANT I:s TO FIELD
1`
yPOSITION-
ELEVATION AND OF , EWER STUB
EXCAVATION
TIO
t .
TO LOCATE BURIED CABLES, GAS PIPING,
t• BEFORE YOU it I r tY ; �,+-••:;.,..-8000)
,ATE ; AND t:::).Nr' 1 ra` "i
E'` !';.:l. OR TO. F? N Y . .
WATER . i..1Ni".,.. , ::'j-':-(• ..
SEWER :':• t t_;S: ti• ARE TO BE:. CrtE::K.t...z. PRIOR I
THAT THEY
~r r r •
CLEAR AND -UNOBSTRUCTED- TO
3*3* iiatt CALL.
$..3)3 7• i PE"• r:''i I i3N P Ei J:.Alx -i i:i
3t•:>;•iE*3t:**** 24 HOi tz
'fttEREQUIRED
hn3nni3rn1}r..;,j
INSURE
SEWER MA_
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