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2001, 07-06 Permit App: 01005428 SewerProject Number: 01005428 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 7/6/2001 Page 1 of 1 Project Information: ....................... . Permit Use: SEWER CONNECTION - EASTON Setbacks: Front Left: Right: Rear: Site Information: ............ . Plat Key: 003152 Name: WYATT ADD Contact: IMPERIAL POOLS Address: 10718 E 25TH C - S - Z: SPOKANE WA 99206 Phone: (509) 921-2251 Group Name: Project Name: ............................................................................. . District: F Parcel Number: 45162.1906 Block: 1 SiteAddress: 10815 E SINTO AVE SPOKANE, WA USA 99206 Location:: SPO Zoning: UR -3.5 Urban Residential 3.5 Water District: Lot: 6 Owner: Name: BRASCH, SAMUEL T Address: 10815 E SINTO AVE SPOKANE, WA 99206-4852 Hold: ❑ Area: .00 Acres Width: 0 Depth: 0 Right Of Way (ft): 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Department Review UTILITIES Review by Utilities Hold Reasons: Permit Conditions: Sewer Permit Contractor: IMPERIAL POOLS SERVICE Firm: IMPERIAL POOLS SERVICE Address: 10025 E 25TH Phone: (509) 489-5674 SPOKANE WA 99206 Item Description SEWER CONNECTION PROCESSING FEE Units Unit Desc 1 NUMBER OF 1 Y OR BLANK Payment Summary::>:::<:»>:::;<:»»::»::> Operator: MKC Permit Type Sewer Permit Notes: Permit Total Fees: Fee Amount $85.00 $15.00 $100.00 Printed By: MKC Print Date: 7/6/2001 Fee Amount Invoice Amount Amount Paid Amount Owing $100.00 $100.00 $100.00 $100.00 $0.00 $100.00 $0.00 $100.00 FROM : JASON & JENNIFER BOEGER FAX NO. : 509 484 1601 07/03/2001 TUE 16:00 FAX 509 477 7532 SPIIKAN O,B/0G-CODE ENF Spokane County Division of Utilities SEWER CONNECTION PERMIT APPLICATION FORM PLEASE NOTE This application form must be (JJed out accurately and in its entirety, and 4=4 or a permit will nae be issued. Also now that sewer permits art valid for 12 months form the tare of issuance. No wttaasions will be granted. A aepsr to rsanht.of.wey permit is required for any work petfosuled in or from the county right-of-way. PROJECT INFORMATION Jul. 03 2001 04:32PM P1 21001/001 Job Address: +t /02/.5" S/ rr-c Parcel Number. Project Name; trim Nor= Lot ---- 'Mock; siltRegislar U Dry Stover O Repair C1 Addition RC1 Abandonment -Residential Ci New © Commercial 0 New Temporary O r tris name: SYS Address: ��/; 992&'b City/Statc Oleir Is any of the work to be performed in or from the county right-of-way? C3 Yee X No s FIRST Tnte CONTRACTORS OR -HOME OWNERS PERFORMING TI -/E INSTALLATION MUST FIRST CONTACT THE UTILITIES DIVISION BEFORE PERMTT(S) CAN BE ISSUED. SIGNATURE OF =TIES DIVIIGNPERSON CONTACTED: Contractor (company name): tie? -- ` Business ! .CP-'- '&y/LI� . 0.00000.61. Sate c liecnsa o bee. � - s o zYJ 2. • Conan Name: Phone Number 11U the table beic ty Co1::raaor (1/different from above): Plsuac Business Rddras; -�4�b6 PG City/graze/2;p PEE INT ORMATION Number of Buildings oorms=ing :o sewer `- `QE_ X (times) 5100 (per bldg? - 3 + S10.00 NOM- OF WAY AFAMIT r -or a strafe joutily ruideecial tail, one pennir is required; ^era rondoavaiaai, towuiausc, dtples; ,riplez or Fuvcpio villa VW:7%111p !as CIO terraim by Iu: lin el erpanee acLicieRsed sepanre snob, one permlr is 'puked iced per =Urea pt. -Awl; • Por a''agto us1dF6 duplex.. triplroi+lrleuzp ..,a1, s awnznhie,o, . p•raaituzagoired • ?Atilt*?Atilt*bu1k6".nse (eporusxrors, iedusrrieI comtakries) if :;chit .. o w permit ,eguirea For balding cooncedeg to tot w.er, (Fox s>•l vi n0Ns NOT APPLICANT SIGNATURE: Method of Payment: D Cash D Check ,Visa 0 MasterCard COUNTY DIVISION OF TJfLITIPS Ate 477-3ao4) DATE:,r� Date= © Discover Card tpire;; Bankcard Number: _ REDACTED Authorized Signature This document originally contained confidential credit card information which was redacted pursuant to RCW 19.255.010 and the o iginal document des oyed pursuant to ' a S DAN GS2014-030. Spokaee County Division o = tale' • '= Cede Enf c rtemeat 1G26 Wm Broadway Avenues Spokane WA 9926o Td. No. (3.10) 177-36.73 Pas No. (509) 477-7198 TDD No. (509)477-7133 �, � C� � 7 —6))//)5,, 4sa»-&'?° 60�, `�- >`A ,Zc