1991, 05-15 Permit: 91000854 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
1 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 m000u with processing. In addition, I have read and understandtmo/mopscrmwnsou/nsmswrswOr/cs
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 ofthis permit/application and any subsequent inspection appmv6s orCertificates of Occupancy shall not be construed to
give authority to violate orcancel the provisionsof anystate or local lawregulating construction, oras a warranty of conformance with the provisionsofany stateor local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OnAGENT DATE
PROJECT NUMBER= 91000854 ISSUED PERMIT DATE= 05/15/9i PAGE= Oi
**************************** PERMIT INFORMATION ****************************
SITE STREET= 1921 % SUNRISE RD PARCELO= 29541-0502
ADDRE%%= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION
***
SEE NOTE ***
PLATO= 000382 PLAT NAME= CHESTER HILLS ADD.
BLOCK:- LOT= 2 ZONE= AGRI DIJTO= E
AREA= 00000000 F/A= F WIDTH= DEPTH= R/W=
0 OF BLDG%= 0 DWELLINGS= i WATER DIST =
OWNER= FLOYD, WILLIAM PHONE=
STREET= 1921 ^ SUNRISE RD
ADDRESS= SPOKANE WA 99206
CONTACT NAME= RON %LOAN PHONE NUMBER= 509 922 8500
BUILDING SETBACKS: FRONT= NA LEFT= NA RIGHT= NA REAR= NA
*****************************
SEWER PERMIT ******************************
CONTRACTOR= ALWAYS ACTIVE PHONE= 509 922 8500
STREET= PO BOX 141562
ADDRESS= SPOKANE WA 9904
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- -------------
PROCESSING FEE Y iO.00
SEWER CONNECTION i 40.00)
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
0505/91 2908 50.0O
------------
TOTAL DUE= .00 TOTAL PAID= 5O.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------ -------------
%EWER PERMIT 50.00 50.00 .00
------------- ------------ -------------
50.00 50.00 .00
PROCESSED BY: JULIE %HATTO
PRINTED BY: JULIE %HATTO
SEWER STUB A%—BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IN TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES,GAS PIPINGWATER LINE% ECT
' ' ^
CALL BEFORE YOU DIG (456-8000)
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
********* CALL FOR INSPECTION PRIOR TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 **********
******************************** THANK YOU *********************************
Project
Address:
E•.
Date
SPECIAL CONDITION CHECKLIST
Condition:
Project #.
Init:
(in)
Appr:
(out)
Ninety days after C/O issuance:
Owner/contractor called regarding the return of plans:
Plans returned: --
No response from owner/contractor - plans destroyed:
Received by:
Date: