1990, 10-01 Permit App: 90005002 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, oras a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PROJECT NUMBER= 90005002
********.r'*******************
APPLICATION
DATE= 10/01/90 PAGE= 01
APPLICATION
*iE*******•***************•*****#a*
SITE STREET= 123 N MOFFITT RD PARCEL„= 16543-0530
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION — B07....1
*** SEE NOTE ***
PLATO= 001654 PLAT NAME= MOFF1:TT'S SUB.BLK.15i OPE'.
BLOCK' LOT:- 'ONE= MIF. AREA=
F
AREA= 000(f :� F'/A=: F' WIDTH=DEPTH= R/W=
0 OF BLDGS 1 DWEI...L..INGE=
OWNER= ALLE:1AND/MOORF PHONE=
STREET= 123 N MOFFITT RD
ADDF.,'...: .:' TF'OKANF. WA 99206
. CIN i AGT NAME= KAROL. ._ TOM STONE PHONE NUMBER= 509 928 771
BUILDING SETBACKS: FRONT= NA LEFT= NA RIGHT= NA REAR= NA
ii ii )i ii• ii 1* * 1t ?i .ii k Si ii Ic'ii n * * ii' h )E ){ },; Yc }i ;' ;i ,s l ,3EWER PERMIT a * H 3I i{ h' i* ;* n 'a * * * h 3i * * u a * 'ii * ;r n ::
CONTRACTOR= TOM STONE EXCAVATING
STREET= 1112 N MAMER RD
ADDRESS= SPOKANE WA 99216
ITEM DESCRIPTION
PHONE::- 509 9211 7710
QUANTITY FEE AMOUNT
----------
PROCESSING FEE Y 10,,00
SEWER CONNECTION 1 40.00
PERMIT TYPE FF:E.: AMOUNT AMOUNT PAID AMOUNT OWING
SEWER PERMIT 50.00 .00 50.,00
50.00 .00 50.00
PROCESSED BY: JULIE SHATTO
PRINTED BY : JULIE SHATTO
SEWER STUB AS --BUILT INFORMATION TS AVA1:I...A)'tl_F AT THF COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES, FCC_
CAL.L.. BEFORE YOU DIG (456-8000)
SEWER STUBS ARF TO BE CHECKED) PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
******•*** [:.ALL FOR INSPECTION PRIOF. TO COVER *********•,'
********* 24 HOUR NOTICE REQUIRED **********
',i' :'N: >': ***** 456-3604 **** * * * **
******•*•**•affair:*********•*****•*•r:**** THANK YOU *****.F..**********7t***"****3 * P' 'Y:
TOPS a FORM 3002P
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