2007, 10-09 Permit App: 07007050 SewerOct 03 2007 4:39PM SPOKANE#COUNTY#UTILITIES 4777178
10/03/2007 14:44 5098921208 LEXINGTON
SEP 08 2004 10i49AH HP LASERJET 3200
Spabeat Canty Diviwfoa d Utilites
SEWER CONNECTION PBRMIT APPLICATION FORM
'(.EASE NOM, Tloie op$iaeon fora moa be Wkd out ateuntel7 and In a mercy, end oral. or. K War tram d. pSc'a * amain +y. "
114
fix 12 monde form the daft of Mom=A atpareee da lel'' ray pant b aye
required for stee rtatesed
as bnmot plumbing .nd Aerie re44 mph= Mont pawn'
•
'AWE sr IlNPORMASfION
p.1
PAGE 02/03
p. 2
ieb
Pane Nambec
Projera Nein
ULM Name
1
JO•oeltmplex nUb, 1
No mss r
chs.4.190KnNnMLA'
pheSt - 1511
Dcf Se.ee
0
o Addition
O Abandonment
o ;I 0 Nee
a Temporary
• FIHST TIb03 00N7'RACIOBS oA Han 097KBPS Par 0%011301121118 IHgTA1 LATION mtIR7 ran cornea THE
=rams rislaaamossrov?(s)'c.}fgssusAFA. GFFGFo¢,"
--!
aso
sxcnATuatrnuintsofvtaoNPHl2oNobiris rBDK.d' Idler 0//3/e7 �{I.
Cm+�.+ed(- .e•l: 4.a. aoamanoe frmee.a�e-. c x c. , . 1 W,a Zp
�,n"" (fin Q �l1v,m N.L—u
Buena eddrersj c p `ha' S;ay� t �ti-S OTRf (�i �1,h�� '/j�� Coe Name /; /} �7.'{�j�� {
eILP 7 t R -.I i LNlSr' arc -a 1 "'!.`C' PAeot rhmdK _ _. l:'�,.`r - V a `(t -- --
INTERIOR PLUMBING ALTERA'IYGb f0as One
RV«eul eie s. fr tie thkr.J .._.
G • 0 Caret! 0 CM of;palma Volk?
Contactor Oct deems from 'lee): Phone
Henries' Add.ts City/Sntr/Zip
`h
r.Iif .WORMATION '
?traitotBradangs tmaeetieS eo mitt X(tmtd) $100 (peibldg SIT •' + ilo•
m na'+tvwar*oaeA•.oam
n-.d'/•Mia'1rarradd:.:4eera+ia.la.R w aneomarlor.igyanralam ra.ra.ak...pooh/ nierkeder anearrodc
•
•
lame sale lady Mkal teen or free e l d/c.eeaM anepn,4i
lee' lava Knww;rdeatdaenda4w6elaa encu ameae seherese.eee yea .an
' a01tSIMATIONS NOT gngt® fBal. CAlLIUE a 'rYUIVICION OPUTIU2 AT 07-304
.Is Qay of &e,vro* to be pctfoated 3a or from the
e6 760-e AJ
APPUCA3'Ir=means;
lic tight•akm?CIYee No •
eapokene Valley
DJ'Th 1_013/197
Method) anstymerta: Unarm C.aed
Dat( EtpitcT
BarOkenn Namhct" - ...
Adlbodacd '
RECEIVED BY
CITY OF SPOKANE VALLEY
OCT 0 9 2001
sPle Ma"(
• &Gs°Hdwaaea* RMIT CENTER