1991, 03-28 Permit App: 91001431 SewerSPOKANE COUNTY DEPIRTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
I certify that I have examined this permit/application, state that the information contained in it and submitted by me or my agent to compile said permit/application is true
and correct, and authorize Spokane County to proceed with processing. In addition. I have read and understand the INSPECTION REQUIREMENTS/NOTICE
provisions included herein and agree to comply with same. All provisions of laws and ordinances governing this type of work will be complied with whether specified
herein or not. I understand that the issuance of this permit/application and any subsequent inspection approvals or Certificates of Occupancy shall not be construed to
give authority to violate or cancel the provisions of any state or local law regulating construction, or as a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
'ROJECT kli'..w'ER= 911r•S :1'.
AF'PL1i:ATT.."
DATE-: 29 f91 PAGE= 01
5 **')t3l* 1 HIS I S NO r A PERMI f ***a'**
PENALTIES WILL. rtc.' ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 12803 E: MAIN AVE:
ADDRESS= SPOKANE WA 9 216
PERMIT USE= SEWER CONNECTION - - C86-2
•)r** SEE NOTE :**
PARCEL. = 15543-2612
PLATO= 001 838 FLAT NAME= OPP.TR. 1-354
BLOCK= 122 LOT= ZONE= AGSRIJ DISTO::: F
AREA: 00000000 F!A= F WIDTH- DEPTH= E'/W=
OF EiLDGS= 4 0 DWELLINGS= 4 WATER DIST :-.
OWNER= GREGERSON, RALPH PHONE=
STREET= 12803 E f MAIN AVE
ADDRESS= SPOKANE. WA 99216
"•QNTACT ` PT.L.L -- SIMPSON SANITATION PHONE NUMBER= 509 92. A;'Ri
BUILDING SETBACKS: FRONT= NA LEFT= NA RIGHT=- NA REAR::- NA
**K************************ SEWER PERMIT WA****************************
CONTRACTOR= SIMPSON SANITATION
STREET= 78.12 E BALDWIN AVE
ADDRESS= SPOKANE WA 99242
PHONE= ';05 976 4•?M
ITEM DESCRIPTION QUANTITY FEF AMOUNT
PROCESSING FEF Y 10_00SEER CONNECTION 4 40.00
PERMIT TYPE. FEE AMOUNT AMOUNT PAID AMOUNT OWING
SEWER PERMIT
t•`ROCE ,1 -;ED BY • JULIE SHATTC
PRINTED BY: JULIE SHATTO
50.00 .00 50.00
-------------
50..00 .00 50..00
SEWER STUB AS—BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (45A-3604)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF ,EWER ST;.i13 PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CAKES, GAS PIPING, WATER LINES, ECL
CALL BEFORE YOU DIG (456-8000)
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOD.5rR41CTF.D In THE .TFWFR MAIN
**x****** CALL FOR INSPECTION PRIOR TO COVER *****d•****
3;:* ..)r.>F**** 24 HOUR NOTICE REQUIRED •******ftiE,•n.
*****u*** 456-3604 •i{•;c•3*x•;x•xu••u•xai-
?F :i• * ?r •)i• •it• * )i• * * iE * • 3i• i>: h 3E r # # • * •)4 ii• * THANK Y Q 1 I •)F •ii ii• •ri ib * •h• 3t k• * ii # ii• )f •ri• 9k k• it • •)s• •)i• # ii• 3F : ii •a' )r k• * 9{ )f :•
DEPARTMENT OF BUILDINGS •
JAMES L. MANSON, C B 0., DIRECTOR
A DIVISION OF THE PUBLIC WORKS DEPARTMENT
DENNIS M. SCOTT, P.E., DIRECTOR
INVOICE
DATED: March 28, 1991
TO: SIMPSON SANITATION
East 7812 Baldwin Avenue
Spokane, Washington 99212
Please make checks payable and mail to:
SPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
West 1303 Broadway Avenue
Spokane, Washington 99260
ATTN: Julie Shatto, Building Technician
REF: Sewer Connection Permit Application
DATE PROPERTY ADDRESS FEE
03/28/91 East 12803 Main/91-1431 $ 50.00
Amount due and payable $ 50.00
Pursuant to your request for the above sewer connection permits, we
are issuing an authorization to proceed with construction, however
payment must be received prior to April 8, 1991. Failure to remit
this amount on or before this date will result in a double fee being
assessed.
Thank you for your prompt attention.
CODE ENFORCEMENT DIVISION
WEST 1303 BROADWAY • SPOKANE, WASHINGTON 99260-0550 • (509) 456-3675
FAX (509) 456-4703