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2004, 10-20 Permit: P0407636 Sewer*** SEWER PERMIT Applicant: LINDSEY CONSTRUCTION INC P 0 BOX 30792 SPOKANE WA 99223 Phone: 509 879 3420 PERMIT NO: P0407636 Connection: BL Approval: DEPARTMENT OF SPOKANE VE ENGINEERING SERVICES III4 1 8 08 W. SPOKANE FALLS BLVD. SPOKANE, WASHINGTON 99201-3343 (509) 625-6700 FAX (509) 625-6349/(509) 625-6124 www.spokaneengineenng org *** CONTRACTOR: LINDSEY CONSTRUCTION INC P 0 BOX 30792 SPOKANE WA 99223 Phone: 509 879 3420 Issued: 10/20/04 Completed: Project No: *0405862 Applicant hereby consents and agrees: 1. To adhere to all rules and regulations in accordance with Title 13.03 Spokane Municipal Code, City of Spokane REMARKS: Inspection area: 4 Proj#/Prof#: 13TH AVE AND END OF CULDESAC Sewer Name:,LLOYD ST BL STREET: 1212 S LLOYD ST YA Parcel No: 35233.05060511 Right of Way: Legal Desc: NORTH 1/2 OS LOTS 11 & 12 BLK 5 "Y -Tap": ENTERS PROPERTY: Depth/Pipe Size & Type: ENTERS BUILDING: Connection to Cess Pipe: Depth/Pipe Size & Type: Fee description Units Inspector Validated by: DAL 0 Easement: 0 Fee/Unit Ext fee Data Application Fee? (Y/N) Inspection Fee? (Y/N) ERU Surcharge (Input Amount)> Was Annexation Covenant Signed? Subtotal Inspections: Total Fees Method Check # CK 232 TOTAL THIS DATE Receipt No. P4#06019 30.00 Y 50.00 Y GFC NA 50.00 80.00 Date Payment 10/20/04 80.00 ********* 80.00