2011, 07-25 Permit: 11003570 SewerSPOKAN COUNTY
SPOKANE COUNTY
DEPARTMENT OF BUILDING & PLANNING
1026 WEST BROADWAY AVENUE • SPOKANE, WA 99260-0050
Site Information
Project Information
Site Address: 2109 N DORA RD
Parcel Number: 35124.0307
Subdivision: DORAS SUB
Block: Lot:
Zoning: UR 3
Owner: KELSEY, CLARK
Address: 2109 N DORA RD
SPOAKNE, WA 99206
Building Inspector: NONE
Water Dist:
Project Number: 11003370 Inv: I Issue Date:
Permit Use: SE\VER CONNECTION
Applicant: TOM GROESBECK EXCAVATING
9914E81'II
SPOKANE, WA 99206
7/25/201 I
Phone: (509) 926-5291
Contact: TOM GROESBECK EXCAVATING
9914 E 8TH
SPOKANE, WA 99206
Setbacks - Front: Left: Right:
Group Name:
Project Name:
Phone: (509) 926-5291
Rear:
Permits
Server Connection Permit
Contractor: OWNER License #: OWNER
SEWER CONNECTION I $125 00 PROCESSING FEE I $25 00
Total Permit Fee: $150 00
•
**POR 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. »' 1
**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 WA STATE DEPT OF LABOR & INDUSTRIES,
INCLUDING THOSE RELATED TO TRENCH SAFETY.
**INS'T'ALLER IS RESPONSIBLE TO INSURE ALL WASTEWATER DRAINS ARE CONNECTED TO TI IE 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.
**SEINER STUBS AND DRY SIDE SEWERS ARE TO'BE"CHECKED PRIOR '1'0 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. •-
**THF: INSTALLER AND THIS PERMIT MUS I BE PRESENT'AT THE, JOB SITE AT TFIE SCI IEDULED INSPECTION TIME.
BOTII STATE LAW RCW 19 122 AND COUN'T'Y CODE REQUIRES THE INSTALLER TO GIVE NOTICE OF EXCAVATION TO
OWNERS OF UNDERGROUND FACILITIES.
Payment Summary
Total Fees
$150.00
AmountPaid AmountOwing
$15000 $0.00
Tran Date
7/25/2011
Processed By: SIIATTO, JULIE
Printed By: Force, Faith Page 1 of I
Receipt #
3109
Payment Amt
$150.00
PERMIT