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2004, 09-13 Permit: P0406252 Meter*** METER PER Applicant: LINDSEY CONSTRUCTION INC P 0 BOX 30792 SPOKANE WA 99223 Phone: 509 879 3420 PERMIT NO: Project No: P0406252 *0405864 SPOKANE DEPARTMENT OF ENGINEERING SERVICES /' 1 808 ,\ E,SWAST FALLS 992 SroKnNe, W nsi iwci ON 99201-3343 (509) 625-6700 FAX (509)625-6349/(509)625-6124 www spokanccngrnccring org *** )� 1T 1 1 1 ) CONTRACTOR: LINDSEY CONSTRUCTION INC P 0 BOX 30792 SPOKANE WA 99223 Phone: 509 879`3420 Issued: Validated by: 09/13/04 DAL 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 LLOYD ST 13TH AVE AND END OF CULDESAC 1214 S LLOYD ST YA 60 35233.05060512 Inside SOUTH 1/2 OF LOTS 11 & 12 Tap Size: 1" Sys;Water Sys; Zip 1 Size - Meter Code: 1" Sewer Meter City? BLK 5 Acct # No. of Units: 1 O Acct Type: RE ; E ; 99212 03 Installed In (bsmt,box): BSMT Fee description Units Fee/Unit Ext fee Data 1" Domestic? (Y/N) TOTAL DEPOSIT Application Fee? (Y/N) Outside City Connection? (Y/N) MUST Customer provide pressure reg- lator (pressure over 80 lbs.)? Y/N Was Annexation Covenant Signed? TOTAL COSTS Method Check # Receipt No. Date CK 220 P4#05034 09/13/04 TOTAL THIS DATE ********* 475.00 Y 475.00 30.00 Y N N NA 505.00 Payment 505.00 505.00