1991, 12-19 Permit App: 91008723 Sewer SPOKANE 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
:.. !t.i;-t , !-•.t:}"t?_`±::.!''•'. .?'Z ;ri!}R—. ....�.? 6+, i:`L1s.SI1...^..uN DATE= ». PAGE= 'I
PENALTIES WILL BE t : +::Er'•S±::.D FOR COMMENCING ENCI} a. Wt,.iRK WITHOUT ;•'•t PERMIT
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±::.. .MIT,t
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*If"* SEE: NOTE *is t
,! .,t_. .r., r.:�:•,.... 00000000 r: ',: ... . .WATER •• ....
OWNER= POTTER . GORDON W. i;HON l:..::::
,.._:E.„..._ C.. ' 1''1-{kJ la 1•,.:- 1-:j I)
ADDRESS= VEPAf;••1±...F WA 99037
CONTACT NAME= H : i _ ? > ; ?_ IiJ PHONE j; : Y. " 8964
BUILDING
SETBACKE :
_..
}«t i.j.±.t...iii.i'•d l,,• .vt t e:S{”!}..:±',,:i FRONT=... �.�,i i�f LEFT= N/A RIGHT= N/A REAR=
: , : t: t PPP: : P: Yt t k` ; *: p . ( i fP * SEWER :: " ' ! ' ; f ;r : sa un1 ( q1 . : { ;* { y }, : : , : :
CONTRACTOR= } • CONSTRUCTION PHONE=
})9 . . 8964STREET= .} i 1 ( E :r r•"••i !t Y'Ll t'.:r. AVE
ADDRESS= '1'i..ii',.�•!N wt. il�:2I.th
ITEM DEECRIPTION QUANTITY FEE AMOUNT
::+I'4iji E;\ .`1:NG Fi':.[: t' iO '"}ii
SEWER CONNECTION t Lal.:; : !;'y!;!
PERMIT TYPE F i••:• AMOUNT (:`iI,'{j1:,-j..2. PAID AMOUNT ;i>,_ii, `•ai.:f
EEWER PERMIT 50.00 .00 50.00
50.00 ,.t:)4} 50.00
r"j
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?�i'-:!.,:.:?::.,•,.>t::. ;s , Art;t"t.t. � ±•�:t.r,,, .t.t.:t"i r ROBIN
PRINTED BY : 3, ONI ..t:i :c: , ROBIN
SEWER STUB i:5 !••t::+—BUILT INFORMATION .E.::'.� AVAILABLE ATTHE COUNTY
Y•.
UTILITIES:: ,-.„_,... n„•.•:-•.,_•-,:•r (456-3604)
CONTRACTOR OR
APPLICANT IE TO FIELD LOCATE AND CONFIRM t_I 1...
ELEVATION A N?.} POSITION OF SEWER STUB PRIOR 1 t.l (•:t N Y OTHER
EXCAVATION
TO LOCATE BURIED CABLES,.. . lq��!,�� PIPING, tr;t y..! .:.?'{ LINES, ECT,
CALL BEFORE Y t.?U A/.±.G (456-8000)
SEWER r , ARE ; BE
r
—E ` i ? PRIOR O CONNECTION TO INSURE
THAT
THEY ('";?'•`.i::. CLEAR f"t a 1;1 UNOBSTRUCTED TO THE-1 E t:.::irsi::i": MAIN
3!:A 1 51 -k !:i!i 3!::R CALL Fi iINSPECTION PRIOR TO. . ..:.1'C ::!!:k p:i!:*)I'k'x-P
!4 9:r Yi it?-'1!i tI 1!!I.:-!': 24 HOUR NOTICE REQUIRED 1t:.,j.),.a.j}.I.Y-'i+'*)-
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