1992, 06-03 Permit App: 92003989 SewerSPOKANE COUNTY DEPARTMENT 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
FCJEC! NUM
iE,APPLICATION O" ( M/03/92 :
.. THIS IS NOT. ,M,,- .. .. .
ii�ic..ir n.rzr• ir. .. ::, .t. :> NOT A FERMI) :'. i•. ,r is ii if
PI:::NAI...TIE:::>' WI:L_L.. HE ASSESSED FOR COMMENCING ixORK WITHOUT i`! FERMI:
SITE STREET= 912 S MAME:R RD PARC%=i..d,=' ,_:'i •;,
ADDRESS= SF'OKANlc. WA :r':?;.-ia.;=:
PERMIT US E- SEWER CONNECTION
•)3H: S I': E NOTE * ii.:,:
WOL..ECREST 2..-560')
PLAT4= v'=° 0E)? 53 PLAT NAME= VERA D 1 1 _ _ DIST
r? ZONE= i.iivl':. 4u::
AREA-. :ijC;:JJ F/FrI- DEPTH=L:
4 OF DLOGS= 1 4 DWELLINGS= I WATER ......
OWNER=
STREET
ADDRESS'
CHURCHILL, PAULINE
912 S MAriER RD
SPOKANE WA 99206
CONTACT NAME= H to CONSTRUCTION
BUILDING "1Y _n".e ; FRONT= N, . ;'=T:N/A RICrIC ;[ti;.v/=
F
ONE NUMBER= SFJ `' _.... 046
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TRACTOR.
S_i.REF
APP' 'IiES:;::
.x SEWER PERMIT
FI S CONSTRUCTION
11817 I:'. V A I.. L.. i:'.'T 1,:J A Y AVE
SPOKANE (IA 9920
i:TE,M DESCRIPTION
PRO'E:SSIN, FEE
SEWER CONNECTION
PERMIT TYPE:
SEWER PERMIT
FEE AMOUNT
50.00
PROCESSED BY: DOM7. ! ROV1(:11, htt.JB1
PRINTED BY: .nr:)r'ii: TRC)VICH, Rni 1
SIi:wE:R :i'TU(1 AS—BUILT INF=ORMAI1ON IS A'I:'i:L_ABL.E AT .(.F.IE COUNTY
ti C:i. L_t : ;. IE: S:' DEPARTMENT i. => _::....,,;;0.e }
lTACTOR OR APPLICANT 7fFIELD A"— N`1 _14 I_
" H-
E G71':C(7N AND POSITION t.n- SEWER SIU:{ 1::!,;:_:r: TO ANY OTHER
AtiA'I ION
}iii: ii: i;: :,;. .;
* i+: p; ip it it ii 9i 9i )E Pi
is
c,
QUANTITY FEE AMOUNT
10.00
40,00
AMOUNT PAID AMOUNT OWING
,.00 50.00
t'„J 50.00
TO LOCATE BURIED CABL_E::S, -Ar PIPING, WATER I [NE`:, ECT.
CALL BEFORE YOU DIG
SEWSTI.IEtS ARE: TOCFa ur,ED PRIOR
lil' ARE (:;i...1 (i''t Fli:tl; l.!i (li'i;'T'Fi1.IC;"i'ED
io-aiacii'ii' CALL FOR ]p1SI:'E::CTION PRIOR 'T(::i
*** 24 HOUR: ivtlT LCE F;E:(;..!IRE.D
A A*e3e)i .) ii iE
THANK YOU ae).***
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EWER MAIN
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