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1992, 10-28 Permit App: 93005016 MH SPOKANE COUNTY DEPARTMENT OF BUILDINGS W. 1303 BROADWAY AVENUE ^ SPOKANE,WASHINGTON 99260 (509)456-3675 /vom,vmut/»o",oxammoum/opermu/unvxouoon.ommmunhommrmanonoonmmoomxanuouum.00uuvmoonnvagentmoomvnoovmv rmit/application is true and correct, and authorize Spokane County to proceed with processing. In additionI have reaand 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 LI,- \'�~~ �\ / > - /�� _//io PROJECT NUMBER= APPLICATION DATE= i0/28/92 PAGE= 01 ****** THIS IS NOT A PERMIT ****** PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT ------------------------------------------------------------------------ -- SITE %TREET= i0:14 H VISTA RD PARCEL�= � ADDRE%%= %POKANE WA 992i2 40 PERMIT USE= MOBILE HOME DUPLEX WITH CARPORTS PLATt= 001288 PLAT NAME= HUTCHIN%ON ' %^ ADD BLOCK= 12 LOT= 6 ZONE= UR-3^5 DI%TO= AREA= 00015624 F/A= F WIDTH= 156 DEPTH= i24 R/W= 40 4 OF BLDG%= 1 0 DWELLINGS= 2 WATER DIST = OWNER= GREEHBURGHERBERT PHONE= 509 922 0569 STREET= 1815 N HUfCHIN%ON RD 059 ADDRESS= SPOKANE WA 99212 CONTACT NAME= HERBERT CREENBERG PHONE NUMBER= 509 922 0569 BUILDING SETBACKS : FRONT= 35 LEFT= 26 RIGHT= 26 REAR= 19 ****************************** REVIEW INFORMATION ***************** ** **** DEPARTMENT REVIEW COMMENT% APPROVAL COMMENT% . . . .„ . ' �� j� �ILDlN� PLAN REVIEW REQUIR[� - --- - - --' -- - ' -- 4 JILDING %ETBAC' ' '' '' '� } '`_�p ' � '^ ~ � ^1 � �4 - - '' -- ` - �]�[}�' 2. �GINEAC| ER APP�O ` /°~' E ' 'DRAINAG 3 'FALTHDI%T NEW OR ADDITIONAL_ WASTE WATER PLANNINOk- UNPLATTED/%EGREGATED PROPERTY � � �� PiAN �F NIN� �� INADEQUAlE REAR YARD TBAC , �-^* '` ^ I i ANHING ADDITIONAL DWELLING ,K)4-E- -/3 -97e; /�}e ^�+4^��^- ' BUILDING PERMIT ************************** - ^ c2.17f / AM= OWNER uy PHONE= NEW= X REMODEL= ADDITION= CHANGE OF USE' . 'DUEL' UNITS= OCCUP, LD= BLDG HGT= i2 STORIES= X 28 SQ FT= 672 EPRINKLER= N OHANDICAP= CRITICAL MAT= N DEECAIPTIQN 17,POUP TYPE SU FT VALUATION Vh 672 4704 . 00 ` QUA#TlTY FEE AMOUNT ' - - -------- ---------- Y 72, 00 KE%I�ENiIA|' �Q�Ch ~ Y i ?.96 F HGME PERMIT *************************3.:- P N PHON MODEL= WIDTH= 20 LENGTH= 40 HEIGHT= i0 ITEM DESCRIP ; ' � ' FEE AMOUNT -------------- -- --- — - - ----- ----^----- TN%PECTICN FEE 4 200 . 00 Y 4 .5; AMOUNT OWING --------- ---- 4 NOTICE It is the responsibility of the permittee, not Spokane County, to see to it that the use described on the front of this permit complies with applicable codes and requirements and that required inspections are requested. Failure to request required inspections and obtain the necessary approvals prior to progressing beyond the point where inspections are required may necessitate removal of certain parts of the construction at the owner's/permittee's expense. At a minimum, the following inspections ARE REQUIRED by County Code: 1. FOOTING—when forms and reinforcement are in place and prior to placement of concrete. NOTE:This inspection includes review of the structure's setbacks from property lines.Minimum setbacks are established by County zoning regulations.Typically,side and rear yard setbacks are measured from property lines, while setbacks for yards abutting streets are measured from the property line or the center line of the roadway right-of-way,whichever provides the greater setback from the center line of the roadway right-of-way. Curb lines and fence lines are not necessarily indicative of property lines.In some residential areas,the County can own as much as 20 feet of right-of-way between your property and the actual improved street/curb.The responsibility to comply with applicable setback provisions lies solely with the permittee— neither Spokane County nor its authorized representatives assume any responsibility for the verification or location of your property lines.Please verify their location prior to locating your structure.Failure to properly locate the structure may require its relocation at the owner's/permittee's expense. 2. FOUNDATION—when forms and reinforcement are in place and prior to placement of concrete.(Blocking for a manufactured home is required to be inspected prior to the installation of skirting.) 3. FRAMING—after all framing, bracing and blocking is in place, and prior to concealing. 4, INSULATION —prior to the installation of drywall. 5. PLUMBING —after rough-in, before covering,and final. 6. MECHANICAL—rough-in of piping, before covering, metal chimneys before concealment,and final. 7. FINAL—when complete and prior to occupancy and/or use. Please provide 24 hours notice. NOTE:In addition to inspection of the structure,this inspection includes review of site improvements(typically depicted on the approved site plan)required by ordinance or as a condition of approval of this permit.Items such as the installation of fire hydrants,fire department access,on-site drainage("208 swales"),road improvements, parking,and landscaping are common requirements of a permit/site plan which must be completed prior to final approval of a building or issurance of a Certificate of Occupancy. In addition to the above any plumbing or mechanical systems or materials which would be concealed by framing, drywall, concrete, etc., must be inspected prior to cover. Check with the department for "special inspections" in conjunction with commercial projects. CALL 456-3675 FOR INSPECTIONS. TO INSURE PROMPT SERVICE, PLEASE GIVE 24 HOUR NOTICE. YOUR INSPECTOR IS UNDER CERTAIN CIRCUMSTANCES, PARTS OF YOUR PROJECT MAY REQUIRE INSPECTIONS FROM OTHER AGENCIES: • road cuts for utilities or drives, State or County Engineer's Office 456-3600 • on-site waste disposal system, Environmental Health District 456-6040 • construction in a flood plain, County Engineer's Office 456-3600 • electrical wiring, State Department of Labor and Industries 456-2792 • sewer connection, County or City Utilities Department 456-3604 EXPIRATION Unless otherwise noted,this permit will be considered null and void by limitation of the work authorized by the permit is not commenced or is stopped for a period of 180 days, unless a written request for an extension of the permit is received and approved by the Building Official prior to expiration.At a minimum an inspection should be requested at least once every 180 days to assure the validity of the permit. A permit may be renewed within one year of the date of expiration for one-half the original fee, subject to certain limitations—please call us if you have any questions. MISTAKES? If you think we've made an error in processing this permit or in conducting inspections pertaining to it; or find erroneous information in the permit,please bring it to our attention immediately by filing a written request for correction within 10 working days of discovery.All such requests should be directed to the Department of Buildings at the address found on the face of this permit. 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 PROJECT NUMBER= 92009492 APPLICATION i)ATE:: 10/2e/92 i::Ai':F,:: PERMIT TYPE ... .. "`E AMOUNT AMOUNT PAID AMOUNT OWING " . MOBILE HOME PMT 2 +..r..0' ....._._...,_. ,00 240 ,50 329,96 ,00 :529 ,96 P Rt' ::: :EST.:% BY : BARRY i..id. S '4._CIE:t-i PRINTED BY : BARRY i•Il.f,`.iE'LOE:tJ i1.yc*•M*aF}{•A:'y:>S':«:bf•H;$:i'!•.H.:14 X 4k ..M...:M..!4*.x.**'k•b:..... THANK YOU i i_i :n*3!• ri•i":•}r*H: i6:.at•ii•ri*ii :••ki•)c*•k•*#a•h:•**�: :" * NOTICE It is the responsibility of the permittee, not Spokane County, to see to it that the use described on the front of this permit complies with applicable codes and requirements and that required inspections are requested. Failure to request required inspections and obtain the necessary approvals prior to progressing beyond the point where inspections are required may necessitate removal of certain parts of the construction at the owner's/permittee's expense. At a minimum, the following inspections ARE REQUIRED by County Code: 1. FOOTING—when forms and reinforcement are in place and prior to placement of concrete. NOTE:This inspection includes review of the structure's setbacks from property lines.Minimum setbacks are established by County zoning regulations.Typically,side and rear yard setbacks are measured from property lines, while setbacks for yards abutting streets are measured from the property line or the center line of the roadway right-of-way,whichever provides the greater setback from the center line of the roadway right-of-way. Curb lines and fence lines are not necessarily indicative of property lines.In some residential areas,the County can own as much as 20 feet of right-of-way between your property and the actual improved street/curb.The responsibility to comply with applicable setback provisions lies solely with the permittee—neither Spokane County nor its authorized representatives assume any responsibility for the verification or location of your property lines.Please verify their location prior to locating your structure.Failure to properly locate the structure may require its relocation at the owner's/permittee's expense. 2. FOUNDATION—when forms and reinforcement are in place and prior to placement of concrete.(Blocking for a manufactured home is required to be inspected prior to the installation of skirting.) 3. FRAMING—after all framing, bracing and blocking is in place, and prior to concealing. 4. INSULATION —prior to the installation of drywall. 5. PLUMBING—after rough-in, before covering, and final. 6. MECHANICAL—rough-in of piping, before covering, metal chimneys before concealment,and final. 7. FINAL—when complete and prior to occupancy and/or use. Please provide 24 hours notice. NOTE:In addition to inspection of the structure,this inspection includes review of site improvements(typically depicted on the approved site plan)required by ordinance or as a condition of approval of this permit.Items such as the installation of fire hydrants,fire department access,on-site drainage("208 swales"),road improvements, parking,and landscaping are common requirements of a permit/site plan which must be completed prior to final approval of a building or issurance of a Certificate of Occupancy. In addition to the above any plumbing or mechanical systems or materials which would be concealed by framing, drywall, concrete, etc., must be inspected prior to cover. Check with the department for"special inspections" in conjunction with commercial projects. CALL 456-3675 FOR INSPECTIONS. TO INSURE PROMPT SERVICE, PLEASE GIVE 24 HOUR NOTICE. YOUR INSPECTOR IS UNDER CERTAIN CIRCUMSTANCES, PARTS OF YOUR PROJECT MAY REQUIRE INSPECTIONS FROM OTHER AGENCIES: • road cuts for utilities or drives, State or County Engineer's Office 456-3600 • on-site waste disposal system, Environmental Health District 456-6040 • construction in a flood plain, County Engineer's Office 456-3600 • electrical wiring, State Department of Labor and Industries 456-2792 • sewer connection, County or City Utilities Department 456-3604 EXPIRATION Unless otherwise noted,this permit will be considered null and void by limitation of the work authorized by the permit is not commenced or is stopped for a period of 180 days, unless a written request for an extension of the permit is received and approved by the Building Official prior to expiration.At a minimum an inspection should be requested at least once every 180 days to assure the validity of the permit.A permit may be renewed within one year of the date of expiration for one-half the original fee,subject to certain limitations—please call us if you have any questions. 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N �3•aa _" ,___39'1 s i E � Ei Y.r u • ml's ss :m a F �n,t�Rgtw�s�ec� UE s®N0E �E. 0■■■ ■■ - 111 - ®O 9 E"3 ammam Y® Fal tBii1__®! N� FE i a. 1 �6 N€ N '- -.. -, ._ ■kJ'C2 H.H�[li Y�r E'.�• 7NiiFi'. 1 , I J. _ -, . '. - t F , e 9 ' F 7 x 4 t s"' rr`sY ��4.,;;,,,,,,. "` ,-` T'4 ''.,`;: , °A ?. . ""'+ � r 'k s z'ek��° eS1 ' t h '� ' �` A.:+ut{ tiffs„ 1 at hI � - s„ ,,,,,,,,,,,p,;.,,,4,,,:„. .)t. 'o-. 1, '-f, k � ' �` 4• + ak ) r 1-, -IA' to 3 i5 ( ,,,� 4”" ° �' R$, k d1 . , 'm * t� ;° «, ti ' t APPLICATIO ' ND •ERMIT FOR ON-SITE+SE AGE,'SYSTEM 0,4 .;iN:;.'1',.,'':e:.(',''I'` SPOKANE COUNTY& EALTH DISTRICT, �J r! ,,- 11C ,rrr. df j r �. ' s� � � L rM., r� �/ /y,��a. \,.1.-1,,,,,'4*,.,::. � PPLICATION•NO. .r�r�Grt`:_ 'fi t{ / V 1 S ro 4'; „ . EN4IRON ENTALI�HEALTNi'i'1)IVISION ,,s,,;,,!,.c� ,, �� , �'•;� / p], .,,,-0...,,' ,�, ,�� 'Ili'' C°fNSUS�.TRACT� �� -� _ . �i w� } s.tkr WES,,r ,,',O1 COY.LEGEs AVENUE ,rt ;, ,`y' -:e . �' ' ..4 i;` 4.'.5 ' .,.; ;ATE.p As.'EICATION' j i ;y' • SPO ANE` WAS IHGTON�` 99201`-2095 (5091�32d 660 INSPECTION REf;•RDING 3241581 -. ,$i 1, S ,E DDRESS'OR'LEGA .DESCRIPTION OF' PROPER Y. ,r,t ;-x �' _ "" &I°" , �� .,, �} 4 � � l ) ' PROPE••Ai"? WITHIN Y PsSSq (,8th/INSIDE.ASA) ,� � � ' `v ' i, ' v �+ s i:.' �- Q�-:, ,, ••, :{ti .f ti'GS.5411:(OUT/1 NSI DEIASA)4 4'7+' Iuz I ' ,:. .,r -� a, / '' � '®%,0 `N;•' i. 4. ;� nS �1VIW►A (OUTSID_ETPSSAIASA GSSA) • �' ? '1.E4AL,0 NEW''F,'P ER . .�� ,`$ DRESS a .‘;';&',),'.f:)"' PHONE:' 7. ) ,'?e,/'. l; OUYS,IDE ALL'Oe. ABOVE!�r r'' =`� • • ,,;;;;;,..4,4*. ' .,, Ike k* 4 •R=.,INSIDE>tASA,ONLY ')'' PR9.0,,yD USE OF PRIP R1Y: (] SING '-FAMI,LY;RESIDE CE NIMB R;OF :EDROIMS r.. °,1),:t ; ;•wok ,. r : }j'e' ,Kaiiyy 4 I� fY TYP/OF'SIRUCTUR MOBIL HOME SPLI ,,ENTRY" MULTI-LEVE e, .,K ,;�, '' , _, ,R ,�k��`�, E*�G] ,, � ��: :]@RANCHER ,.a., []�,�". �� 3 [] ,. r�, n .• j7TM' MUL I-FAMILY COMPLEX "NO: IINIkTSr_ ,, O: :BEDROOMS/UNIT'''9"5L` - i;i '` �k : ` jI=COMMERCIAL/INDUSTRIAL ( E CRIBE): 3.' 'I-e.ki9-`' EMPLOYEESr .": "(SEATSA%CHAIRSjFOR`CL�IE TS/CUSTOM S�`4, �� I,$(S7HIS,PROPERTY:.L``OCATEB,.WI,THIN.4kCOMMUNITI(;PUBIiIgSEW R SE VICE AREA r,=,,tF?C1-YESt [l,-00:z ' iT ^e> "�,� „a`, V`` , •IFNYES;'NAME OF DISTRICT/SYSTEM: : ? ,°'-� .', - ' ` ':IS'`ULID. AGREEMENT4 REQUIRED?; '14.1.YE50-C =1A Y# i` ,,flier t,7 .. r +,R.a t i ..SEWAGE. SYSTEMI`COMPONENTS: .V t ;G 9x. , ;N 3, :,,f!! . �3��::'%A db `ws�P' OPOSED SYSTEM'BY APPLICANT ' ., s." •'r ,, 41 =s ],REPLACEMENT/.FAILURE;tr' Y S'` NO ALTERATION QYE IQ .' I'° �a f yF, +g„fai. „TANK(.§) NO •_I! I SIzi :0 •!�” - j` REASO)J '.r ,t,i4 ]f oy`t r [xRELOCATES CONFEICI."-Y=• vj °F (,I , OTH Ra PRETREATMENT FACILITY 'r r t r URATIONN/S0 1ZC {IMG OF US:a A�`"� tas';' Xi'.i -s` ""w '';(SPECIF1•411'41t4. 2 ak i,K , a b°;:m ,, r la []r�0 HER': 'r� .1 4} �'"• y AUI 0 I$ d, ^ f '4',''► DRAIMI ELD` T I , .[+],.LEACHBEI-...'• '`¢;fr;`.:!..1-•:':-1.:147.;.,:.;. 1 ;I ';-a: :yr 1r df'1t- Its lr' C " `1 ' ';1 , £: \ �. ]1,A U ,LDI G. �WE ' f• [-]3 OT, E N I�K:S.ECIV,:':!f,,Y:n' WIL '"•TH RESULT t'IN,ANs'INCREASED SEWAG ,F I 7 IBES`„+la NO °; +rk�‘_ te, .,: i + � a'` , 4 % 4 °:[� A NEW+tS.YST Mt r,,. � t WHAT IS"THE,SOURCE OF�IATER FOR-THIS PROPERTY F PUBLIC/SHARED W TER&1S 1 EM, NAME ;AIjiM/ ,„,,_:,,;,,g; "till , •,,,t ,, ' ,, -..1q.''';)Ptt IV `PRIVATE: j 1 WEL"' �r Oft P'RING . ' F J' AKE [) 2929.4`APP IES'*.1 2929 DOES,NOT APPLY PROPOSED PLOT PLAN) St1O ACCOMPANY'1HI APP''rr} LON,AALONG WITH ANY, 0 HER PER11NEN1- INFORMA110N.�'SUCH ASSLEGAL DESCRIPIION OF 4, " ,,F ' ..:., H ,f 1' t #4< 4 fat 7 11 PROPERTY. •%; �i11 'i; �'� �`I � _. � '�- - .. 1HISSAPPLICATION'.AND a PERMIT APPROVAL',IS CONTIG N14iUPON MEET INGy,RE U yREMENTS SET FORTH IN THE SPOKANE COUNTY,�{'HEALTH DISTRICT. RULES' AND REGULATIONS1FOR ON—SITE'/SEWAGE SYS:i APPROVAL IS(BASED ONt'THE""ACCURACY OF THE INFORMATION SUPPLI O,:BY THE API,,LICANT ' IF•YOU AR ,DISSATISFIED WITH THE D C ON.�OF 1HE HEATH;DISTRICT YOU MAY APPEAL TO THE,HEALTH,'OFF:'CER WITHIN TEN x ,,, (10)Z DAYS'OF-DENIAL O .'THIS APPLICATION (SEE+APPEA .PROCEDURE'106TLINEO4'IN THE REGULATIONS). + 'r' i CONT CT E SON: .� PHONE( •,;,.44%.„:,,, GN TARE'OF OWNEf OfR U H IZED REPRESENTATIVE: 4'41r` „m 41,'` . , +� ;: ,gt.',',✓ 7Ats f " , '4 'r7,' �� - ` t('' .� r - - 'MAIL"P RMI1A COPRESPI DENCE TO , Ems ,y r r" , k r r s, + I;,r Vis`' :'itt ' t INSPECTIIO 'C LL� 'IAT '. - FEEtPAYMENTS: ANT.'PAID'" DATE " ' REG"'; `b 'PAID :Y r - 1 t1 ;TESTIHOLE'INSP 1" a -c/27: /b` , % •.,,-,4.0',7. "APPLICATION : , fI 1" 1 '.•A;, `PARTIAL INSP %� a . s :`< PERMIT -x'- ' 1• 1l// 3i1 �' 7W ` :I`� ' 'r 'i'FINAi.iNSP: ?<.':., (,Chr m hlit°rl°'. REINSP z#4 ,/.REINSPECTION - ^ "]li- t, . " r.. q,,..• ;'r 4.s e.4 'PCAN)4R ' EW' 1 :: - D ''4rT' /'',rra,r''- 'EXPOSURE ., lI<t r);s+ I t�*F''i RENEWAL- a, 1 E p A ill . .,.. a „J ( 2929�REVIEW 1+ ,: '.`�P_ '1"4"e' CHEDUL.E O',� Q1%ALS •"(] -` ' �~ . ` 4� CRI;TICAL-MATER IAL'USER YES c: w 1 �, ` �4 POST"'��Y`�;7 ,s ,- L ,, 1 + )SEWAGE'MAINTENANCr'AGREEMENT,-REIUIRED?; if 4 .,,,44-0..,,OATEI °100-FOOT-SETBACK REIUIRED?r ; ' YES 4 1 ' ASA/SCHEL DENSITY,.REIUIREMENTS': . ES::‘,. . t .`,I . + 4•`= e1v 04,440,`-EASEMENT,REQUIRED? •-;;-:.„,...•4; tN t11YES'1F4Ne-",• , , 0 HERpAGENCY 1 e' Ut tles,' •a nin. OH yAP OVA DATE, °` E 1,�HOLE,'PPROVAI_: NATUR ' D.=DATE ),j � -k;4 , '�'i,; ' R, 1J' :�"."..' J4 } ,f ., +,,, -,4):,, e9..w°Mi•r ' ..i.' :' t.r i , sr P _ M� IIMo �r M S ATIONS BY I 4. 1.1. 4= Y� '0a RATE,_;)O46AL/OAY',DOSAGE VO ? (• CYCLE il'ISP L FACILITY, .,y';t.; .i. X !! kA HENT FACILITY ay a - l ..,,.„-,,,-..„-7 $; a s -1. ,_;` I. _OItAINFIELD SIZE L LO4l,'RATLIj (SOI ).,kiy ZING RATE O`• b t I OTIC::TANK SIZE ,,1 f I"' t'+ x� . . GALSI/FT? x 3G kt', TRENCH WIUTN .. .g O d -LINEAL-FT. ' I []`GREASE,'TRAP SIZES4i 's rI GALS `f}1I [] LEACNBED: FLOW RATE" '4SOIL LOAD A E , ti a 4{,�� yb 1, +o�,.-r Y �` a �, R .-t (]LPUMP'CHAMBER SIZE`' ""- GALS" 1I 1',. ), GALS,/FT =`4 T �� SQ r FT't z '.�' P.] SAND`FILTER BED F'LOW;RAT E : 1'2 GAE i.' ' F []ALTERNAIIVEN [T]MOUND. []PRESS �` s� SAS ()SAND FILTER r '@]-,�HOLDIN6.TANK:'� :Atii '' 'i‘,,64:, ��i, NO`,- ' , 1[]OThER (.SPEC�IE,Y)': ',! ' � ,.g . 4 Pi:,BUIL0ING'`SEWER [IOTHER: g., 1-. > :-‘ X, SEE ALTERNATTV 1 SYSTEM SPECS w1 ATTACHED, ,,. OTHER E H. PROGRAM APPRpVAL AND:',DAT I', AP':I',1 I, '',:,..':9 ` ; =TURE A JI i4'ATE ' D,OUBCE PLUM: N REQU I - I , : '�.,r'.L� 74:, _" "' IDS 'SE p :1 I I� [lREQUIRED M RECOMMENDED'1 4kN/A ! S ' PLIVi 11r1� �a (+',, ]208 REQUIRE' D'^' LID TO APPL". DATE• C/ * ';. PERMIT ISS EI DATE =t,� -- XPI'E ,' . IALS: i;<; • A SEE•PLOT PLAN ULID RCV'D'DATE: 1 -• , '"o ,,,44,#4 ,,N `''";, • I" INSTALLER:; (PHONE NUMBER) (INSTALLER SP.rAT1'E) , FINAL •SP T IN SIGNATURE'Ai0' 1,. E., a ',- L/ I $ 41.. . •''Lim >-. I .JL / 97 REMARKS AND APPROVAL CONDITIONS: ,(see reverse side ale.. ) t + •I SCHD-EHD-0532P(REVISED 5/92) FUTURE SEWER zl',,VICE AREA FORM FOI_LOWUP DAZE: .":= l