1991, 07-08 Permit: 91001657 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, 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= 91001657 ISSUED PERMIT DATE-: 07/08/91 PAGE= 01
************************* PERMIT INFORMATION ****fix••******* •******** • • •*ask
SITE. STREET= 11005 E 23RD AVE PARf.;FI._O _= 28542-3316
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION - - NORTH KOKOMO
** SEE NOTE **x
PLATO= 001393 PLAT NAME= KOKOMO TOWNSITE
BLOCK= 19 LOT::- ZONE.:-: AGSUB DI:STF::=
F�
AREA= 00000000 F/A= F WIDTH== ?? DEPTH= 139 R,•'W=
:e OF BLDGS== i :d: DWELLINGS= i WATER DIST :_.
OWNER= KANE: ROY S PHONE=
STREET=1 100? E 2 ,5RD AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= DONNA COURCHAINE: PHONE NUMBER= 509 924 5485
BUILDING SETBACKS: FRONT= NA LEFT= NA RIGHT:-- NA REAR:- NA
:p *•****•******************4x*** SEWER PERMIT •tt ••>k•x** :**••*x•*x**** •*** •* •xa;*u
CONTRACTOR:- COURCHAINE CONSTRUCTION
STREET= 16402 E VAI...I...E:YWA'f'
ADDRESS= VFkADAI._E WA 99037
]:TEM DESCRIPTION
PROCESSING FE:E
SEWER CONNECTION
PHONE= `i09 924 5485
QUANTITY FEE AMOUNT
10.00
1 40.00
*****xxx-xxxxxk*x********* ***** PAYMENT SUMMARY*xxxxxx•xxxxx**x•xxxxxxxx:*•;t*xx
PAYMENT DATE RECEIPT:„ PAYMENT AMOUNT
07108/91 4473 50.00
------------
TOTAL. DUE • .00 TOTAL PAID:::: 50.00
PERMIT TYPE: FEE:: AMOUNT AMOUNT PAID AMOUNT OWING
SE::WE:F. PERMIT 50.00 5000., 1' 0
-------------
}0..00 50.,00 :.00
PROCESSED D BY : JULIE SHATTO
PRINTED BY : JULIE SHATTO
SEWER STUB AS—BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE: AND CONFIRM THE:
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING;, WATER LINES, ECT.
CALL.. BEFORE YOU DIG (456-8000)
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARF CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
xx-******* CAL..L.. FOR INSPECTION F`F.)OR TO COVER x•xxxxxxxxx
x•****x•*xx 24 HOUR NOTICE REQUIRED ***** ai'***
ak******** 456-3604 3604 xxxxx..***
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Project
Address:
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Date
SPECIAL CONDITION CHECKLIST
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