1990, 01-09 Permit App: 90000111 SewerSPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
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
PROJECT NUM(il=90000111 DATE= :
APPLICATION
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SITE STREET= .ti i ., � 4 S !'': t.i B .!. 1::. � } I "' A .'{`...: 1::. _. -x• _.. 33541-0110
ADDRESS= i::(.Jlif)I'JE::. WA 992::6
PERMIT ii.... i..l:'1:::= SEWER CONNECTION
PLATO= y);-)4: c? PLAT NAME= MTn,Tt..c)i�1E: �_•-r •• ADD
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BLOCK= • .i LOT= 10 ZONE= SFR T) :i: ," f' 4::::
.IL OF .(.t I... D (.Y E -:' 4 D ISI E l... I...1: P'1. (.Y ,} __ '1
OWNER= i.ixEIJDAHI.. (:'.(ltd; •T.
STREET= I::' (:) C:t i 4 3 ,} 4
ADDRESS= "' i C b I 99214
'CONTACT NAME- ,,..l.t::, ,
PHONE= 509 924 6961
PHONE NUMBER= 509 92.4 6961
BUILDING SETBACKS.: FRONT= NA LEFT= NA RIGHT= NA REAR:::: tJt.,
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DATE
DEPARTMENT NAME • REVIEW COMMENTS IN/OUT INITIALS
COUNTY UTILITIES
CONNECTION r,ti=EMle; REQUIRED 9001 09 ; DH
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CONTRACTOR= STANLEY (:J)<:I:::NTf)E1L.
STREET= 4310 S.: HOLLOW c::.T.
ADDRESS= SPOKANE WA 99206
PROCESSED BY: Tr.:VE:: !"i CiL..`r k:
PRINTED BY:STEVE I'd(:iI...`Y'K
509 t' 924 6961
**********************§********* THANK Y o I.J ***********K*********************
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