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2010, 08-16 Permit: 10004256 SewerSPOKARE Cann( SPOKANE COUNTY DEPARTMENT OF BUILDING & PLANNING 1026 WEST BROADWAY AVENUE • SPOKANE, WA 99260-0050 Site Information Project Information Site Address: 1219 S DISHMAN RD Parcel Number: 45203.0802 Subdivision: CITY OF SPOKANE VALLEY Block: Lot: Zoning: UR -7 Urban Residential -7 Owner: RYCHALSKI, GAIL D Address: 1219 S DISHMAN RD SPOKANE, WA 99206 Building Inspector: NONE Water Dist: Project Number: 10004256 Inv: 1 Issue Date: 8/16/2010 Permit Use: SEWER CONNECTION Applicant: RYCHALSKI, GAIL D 1219 S DISHMAN RD SPOKANE, WA 99206 Contact: RYCHALSKI, GAIL D 1219 S DISHMAN RD SPOKANE, WA 99206 Phone: (509) 926-7580 Phone: (509) 926-7580 Setbacks - Front: Left: . Right: Rear: Group Name: Project Name: Permits Sewer Connection Permit Contractor: OWNER License //: OWNER PROCESSING FEE S15.00 SI SEWER CONNECTION • 5125,00 Total Permit Fee: $140 00 **FOR SEWER INSPECTIONS CALL THE UTILITIES DEPT AT (509) 477-3604 FROM 8:30-5:00 MONDAY -FRIDAY PRIOR TO COVER. ONE WORKING DAY NOTICE REQUIRED. PERMIT ALLOWS FOR A 30 -MINUTE INSPECTION. ADDITIONAL INSPECTION FEES APPLY AFTER 30 MINUTES. - **CALL 1-800-424-5555 BEFORE YOU DIG --AT LEAST 2 WORKING DAYS IN ADVANCE. SPOKANE COUNTY CODE REQUIRES THE INSTALLER COMPLY WITH ALL REQUIREMENTS OF THE \VA STATE DEPT OF LABOR & INDUSTRIES, INCLUDING THOSE RELATED TO TRENCH SAFETY. **INSTALLER IS RESPONSIBLE TO INSURE ALL WASTEWATER DRAINS ARE CONNECTED TO THE SEWER AND MAY BE REQUIRED TO PERFORM TESTS FOR VERIFICATION. INSTALLER IS TO FIELD LOCATE AND CONFIRM THE ELEVATION AND POSITION OF SEWER'STUB PRIOR TO ANY OTHER EXCAVATION. **SEWER STUBS AND DRY SIDE SEWERS ARE TO BE CHECKED PRIOR TO CONNECTION TO ENSURE THAT THEY HAVE ACCEPTABLE GRADE AND ARE CLEAR AND UNOBSTRUCTED. SEWER LINES SHOULD BE CONSTRUCTED TO ALLOW FOR GRAVITY FLOW FROM THE LOWEST LEVEL OF THE STRUCTURE. **THE INSTALLER AND THIS PERMIT MUST BE PRESENT AT THE JOB SITE AT THE SCHEDULED INSPECTION TIME. BOTH STATE LAW RC\V 19.122 AND COUNTY CODE REQUIRES THE INSTALLER TO GIVE NOTICE OF EXCAVATION TO OWNERS OF UNDERGROUND FACILITIES. Payment Summary Total Fees $140.00 AmountPaid AmountOwinr $140.00 $0.00 Tran Date Receipt # Payment Amt 8/16/2010 3460 $140.00 Processed By: DOMPIER, DAWN Printed By: Force, Faith Page - 1 of 1 PERMIT