1991, 05-21 Permit: 91002761 MHSPOKANE 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 canc = he 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 )'j) / DATE
APPLICATION
OWNER OR AGENT �° '
NUMLH- 9-100276i
JROOK
V( 2...?' ... ...
PARCEL:;;:- 2454i -T126
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WA UNKNOWN
liEM F1' QUANTITY
PHONE -HEIGHT-
HEIGHT- 10
FEE AMOUNi
........................................
50
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PAYMENT DATE
...........................................................
AMUUNi
3001
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120„50 ,00
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SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
. SPOKANE, WASHINGTON 99260
(509) 456-3675
compileI certify that I have examined this permit/apPlication, state that the information contained in it and submitted by me or my agent to m 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
PROJECT NUMBER= 91002762
I%%UED RMIT
**************************** PERMIT INFORMATION ****************************
%TREET= 17015 E MEADLN
ADDRE%%=
SPOKANE WA 992i6
�ER CONNECTIGN
***
PERMIT
***
OWNER= WERNER ELISE
%TREET= 17015 E MEADOWBROGK LN
ADDRESS- SPOKANE WA 99216
DEPTH=
=
PHINE= 627O
CONTACT NAME= ELISE WERNER PHONE NUMBER= 5O9 838 �Z/o
BUILDING %ETBACK%: FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** %EWER PERMIT ******************************
CONTRACTOR= OWNER PHONE=
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- ----------
PROCEING FEE 10,00
SEWER CONNECTION 40.00
*************************** PAYMENT %UMMARY ***i:*********************
PAYMENT DATE
O5/2i/9i
TOTAL DUE=
PERMIT TYPE
-------------
%EWER PERMIT
PROCE�
RI.
RECEIPT4
3O88
FEE AMOUNT
-----------
50,00
-----------
50,00
BY WENDEL, �LRIA
BY: JULIE ^HATTD
%EWER
117"!: ,
AMOUNT PAID
PAYMENT AMOUNT
AMOUNT OWING
------------
.00
------------
.00
%TUB A% -BUILT INFORMATION J% AVAILABLE AT THE COUNTY
DEPARTMENT (456-604)
CONTRACTOR OR APPLICANT I% TO FIE
ELEVATION AND POSITION OF SEWER -
EYCAvATION
TO LOCA
CALL BE
LOCATE AND CONFIPM THE
pr.:! TO ANY OTHE�
BURIED CABLES, C;A% PIPING, WATER LINES, ECT.
�E YOU DIG (456-8000>
ETUrk
,,Hi |MLY
*********
*********
*********
TO CONNECTION TO INSURE
TG THE %EWER MAIN
COVER **********
**********
*******
**************************** THANK YOU *******************************