2010, 12-27 Permit: 100006909 SewerSPOKE COUNTY
Site Information
SPOKANE COUNTY
DEPARTMENT OF BUILDING & PLANNING
1026 WEST BROADWAY AVENUE • SPOKANE, WA 99260-0050
Project Information
Site Address: 4414 N EVERGREEN RD
Parcel Number: 45022.3002
Subdivision: TRENTWOOD ORCHARDS
Block: Lot:
Zoning: UR -3 Urban Residential 3.5
Owner: SAMPLES, DAN
Address: 4414 N EVERGREEN RD
SPOKANE, WA 99216
Building Inspector: JOHN LARSON
Water Dist:
Project Number: 10006909 Inv: 1 Issue Date: 12/27/2010
Permit Use: SEWER CONNECTION
Applicant: H & R COMPLETE
PO BOX 749
NEWMAN LAKE, WA 99025
Contact: H & R COMPLETE
PO BOX 749
NEWMAN LAKE, WA 99025
Setbacks - Front:
Group Name:
Project Name:
Phone: (509) 218-8336
Phone: (509) 218-8336
Left: Right: Rear:
Permits
Sewer Connection Permit
Contractor: H & R COMPLETE License #: HRCOMI*972DD
PROCESSING FEE
1 $15.00 SI SEWER CONNECTION 1 $125.00
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 WA 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 RCW 19.122 AND COUNTY CODE REQUIRES THE INSTALLER TO GIVE NOTICE OF EXCAVATION TO
OWNERS OF UNDERGROUND FACILITIES.
Payment Summary
Total Fees AmountPaid AmountOwing
$0.00
$140.00 $140.00
Tran Date Receipt # Payment Amt
12/27/2010 5581 $140.00
Processed By: DOMPIER, DAWN
Printed By: Force, Faith Page 1 of I
PERMIT