2005, 08-23 Permit: P0506728 TapAPR -25-2007 WED 12:15 PM FAX NO.
***
Applicant:
MDS SHULER INC
P.O. BOX 1207
DAVENPORT WA 99122
Phone: 462-3027
PERMIT NO: P0506728
Project Nos *0508427
SPOKANE
C. W
DEPARTMENT OF
ENGINEERING SERVICES
808W. 51'I1KAN{? FALLS BLVD.
SIYIMN{y WAti1IINl;1oN99201-3343
(509) 625.6700
FAX (509) 625-)349/(509) 625-6124
TAP PER ***
Phone:
Issued: 08/23/05
Validated by: DAT,
In applying for City water service, 1 agree:
1. I am bound by City requirements, including those of
Spokane Municipal Code Chapter 13.04 and all terms and
Conditions of the Water Rates Resolution, as last
adopted by the Spokane City Council.
2. To arrange for City inspection of the water connection
prior to covering.
3. To pay all charges, including the DEPOSIT. PRICE WILL
BE SUBJECT TO CHANGE, it not installed within one year
from the date this permit was issued.
Signed By;
Connection:
Tap On:
Between:
STREET:
St. Width:
Parcel No:
Legal Desc:
DOM
CHRONICLE
14TH AVE AND 15TH AVE
1425 S CHRONICLE RD YA
60
Acct #
No. of Units:
RE
35233.1511000B Inside City? 0 Acct Type:
WOODLAND TERRACE S 1/2 LOTS 9 & 10 BLK 15
Main Size and Type: 8"
Tap Size: 1"
Sewer Sys; Water Sys,Zip 1
Pee description
; E 1 99212
Units Fee/Unit
1
Ext fee Data
Application Fee? (Y/N)
Outside City Connection? (Y/N) . >
Was Annexation Covenant Signed?
1" Tap? (Y/N)
TOTAL DEPOSIT . . . . . . . .
TOTAL AMOUNT DUE
Method Check # Receipt
CK 2544
TOTAL THIS DATE
No.
30.00 Y
N
Y
296.00 Y
296.00
326.00
Date Payment
08/23/05 326.00
********* 326.00