1991, 10-01 Permit: 91004346 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 130)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 NUMBER= 91004346 PERMIT
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{. I i:: :. i K i.. i :::: .; 224 E ))3''3',.'l,31"E!`-.C.,i::.i....,!._.. .... .... .
ADDRESS= .... ..i 1'..t+'i r'•t i:` ti.l{�:S.. 99216
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USE= :::`�:: 3
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PERMIT ,.�i
PLAT4= 999999 PLAT NAME= RANGE
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= AGRI
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4 OF BLDGE= 4 DWELLINGS- i WATER DIET :3:: MODE: RN
OWNER= :.?`..:t`.,i? i DONALD PHONE— c24 0059
ADDRESS= _.P KANI::. .... 99216
CONTACT NAME= LARRY COOK PHuNif:. NUMBE — 709 466 2192
BUILDING SETBACKS : FRONT,. NA ....i::.I:. ... NA RIGHT- NA . ....AR .. .
: : : i : : ; i.: : UJ: t :i : : ?1:t :i : * !*: . . . IIPERMIT "I....................... 3.
COOK
OONTRAOTOR= LARRY EXCAVATING
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ADDRESS= NINE MILE FALLS WA 99026
ITEM DESCRIPTION QUANTITY FEE AmIUNT
PROCESSING FEE 1C „OO
SEWER CONNECTION 4c. ,00
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................................... ............
SEWERTOTAL DUE,. , 00 TOTAL PAID= 5 , 00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT
PERMIT 50, 00 50,00 .. .
-------------
50 „00 ... .. .. .. .. ..
JULIE SHATTO
PRINTED BY : JULIE EHATTO
SEWER 1- i•i. INFORMATION •i.:. AVAILABLE I _ COuNTY
AS—BUILT UTILITIES
i, l
t
DEPARTMENT
` f"
CONTRACTOR APPLICANT E{ r i AND .i.?
M THE
ELEVATION AND POSITION OF SEWER ETUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE j''
URIED CABLES, GAS PIPING , WATER ECT „
CALL BEFORE YOU
i t
SEWER ETUBE 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
.i.:11.:ai.:•j.:!j.:!i.:!i.:v;.:}j. :i, REQUIRED
'THANK you
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