2007, 10-04 Permit App: 07007015 SewerSep 20 2007 5:O1PM SPOKAMEIICOUNTY#UTILITIES 4777178
' 09/20/2007 15:28 5098921208 LEXINGTON
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SEP 08 2004 10:4589 HP LASERJET 8200 RECEIVED B'i.z
SpokoneCounty Division ofUti& CITY OF SPOKANE VALLEY
SEWER CONNECTION PERMIT APPLICATION FORM
PLEAS , ND7R The p gatioq form Heart be Med an 'morn and in is entirety, and ailed, -. permirt a,i .. be iQieUT'4Vela" 2IJfs' Le n14
Far 12 encodes tb= the date of isionnee. A saran dghMMny perms is piked far ware* peefwanat in az from the Mit e1gN-Mary.
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PD •e )x 11400
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Pboec gig 150
• Mtn Ea16 CONTRAGIDRS OR HOMBOWMERS reetroncgs TT181NSTN►ATION MOST FIRAT CONTACT Eli
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• WOR rnsstnONS Hon ocinwa HBRE.cannacourt arnston ortrraIIESAX OAsae4
1<s aery of the sock to be pa/loaned it or livid the , , ; right-of-way? 0 Yes 0 No
APP•LICANr SIGNATURE,
aESpofane Valley
_Mixt et mlize
DATE: 2M/12
.Me bod eE Prgeeat
a Cut a 060k . a Val • 4 'MaateaCaad 0 Disarm Cad'
Date:
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