2003, 09-17 Permit: P0305472 Tap***
TAP PER
Applicant:
MDS SHULER INC
5813 E 4TH AVE SUITE 102
SPOKANE WA 99212
Phone:
PERMIT NO:
Project No:
462-3027
P0305472
*0308971
SPOKANE
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MANOR
CONTRACTOR:
MDS SHULER
5813 E 4TH
SPOKANE WA
Phone:
Issued:
Validated by:
DEPARTMENT OF
ENGINEERING SERVICES
808 W SPOKANE FALLS BL\'D.
SPOKANE, WASHINGTON 99201-3343
(509) 625-6300
FAX (509) 625-6349/(509) 625-6124
www.spokaneengineering.org
* * *
INC
AVE SUITE 102
99212
462-3027
09/17/03
SLH
In applying for City water service, I 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, if 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
13TH AVE
CUSTER & LLOYD
1307 S CUSTER ST
60
Inside City?
Main Size and Type: 8"
Tap Size: 1"
Sewer Sys; Water Sys;Zip 1
Fee description
Acct #
No. of Units:
0 Acct Type: RE
E ; 99212
Units Fee/Unit 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 No.
CK 3959 P3#05545
TOTAL THIS DATE
Date
09/17/03
*********
30.00 Y
N
NA
280.00 Y
280.00
310.00
Payment
310.00
310.00