1991, 11-07 Permit: 91006003 Sewer 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
' C f „ iT NUMBER=
UMBr1 = ';,/•+ ,:?t.!t+t ?s::l3 ISSUED i'`?':.:':f`tI1 7;-7 T.. /07/9-! PAGE= s::!"t
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{.,.}.T i STREET= 13621
_ ,r•. E: 3RD AVE r. . _ 22m;4i -9i77
ADDRESE= SPOKANE WA 99216
PERMIT :: SEWER CONNECTION ULID 903
};'},.."' S E i;:, NOTE *•j,.:
,,
LAT NAME— RANGE
BLOCK= LOT= ZONE= UNK DIST4=
AREA= 00000000F/A= - WIDTH= DEPTH= i• .'`iii::::
OF 1:t1... ?i:r,`,.... 4 WATER 7% !.,:• E
OWNER= OSBORNE PHONE=
STREET= .1362.1 E 3RD AVE
(''±.t%rj i"•`.E ):.. •• SPOKANE tr;i i 99216
CONTACT NAME=
± 'rPHONE
RIGHT= = :i
509 926i8964a
BUILDING ;. tA - ' . FRONT= `o . " FT . ;NJA ; "( i : NA
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CONTRACTOR= ;••t :< :y CONSTRUCTION P .._Tt!.:.... 509 9268964
AVESTREET= 11817 E VALLEYWAY
?D?DI'Li::.JS:.. SPOKANE WA 99206
ITEM E!”! I?ESc::•t l :t c:i QUANTITY FEE AMOUNT
PROCESSING-,S':'::•':1:NEv F .:E 't` 10.00
iSEWER CONNECTION I 40,00
± a t 'r: ...•• •�..jG•i•:•'fisi•jr:�t+: �;9si 3s:•'J::rJt;its;3C•�n:h: •ii••:�;n:3?••x:-ls'•�:.n:•:tr-v:•n:•1s:
*KK**************************** 7-'f•:±�!".!::.!''. :}i.�t!s!. ! [ ;
pAymENT DATE: RECEIPTO PAYMENT AMOUNT
11 /0 7/91 8264 50•,00
TOTAL DUE= . 00 TOT AL PAID= SO . M
PERMIT ifP± ! tAMOUNT A;OUNi PAID, t Aq: i OWING
SEWf.:.f. PERMIT
50..00 50.00 ..00
50. 00 50 ,00 ,00
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PRINTED
TE• " YJULIE
i , , _
SEWER STUB lw. eri ! INFORMATION � AVAILABLE Ai THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR t (•?P!••I....I.t.:ANT .;.:':. € t.l FIELD LOCATE t-?i�•x? CONFIRM I :'(::.
ELEVATION Ax D POSITION , ' SEWER y ! _ i PRIOR , ANY L
EXCAVATION
LOCATE 3 : ; . TCABLES, GAS - :I NG WATER LINES, .' . .
CALL-` BEFORE YOU f,J r C ( 456-8000)
SEWER : tB ARE! s O ifCHECKED PRIOR CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER
MAIN
1:..1t:9?':R•3t:Js:7k•jt:h: CALL I"'..:R .:.y.1 t.'t"i':.C T.!.O{VREQUIRED
:'�'S.t.(i f�� ! ±..� COVER .y.�:i::i it:•'ti•-ii•Ni•n:�+:
:ti}f:!t.j�..j(..ss..j,.:.;..j• :'�. HOUR NOTICE t•C 1-.Q t.J.!.!"':I::.%? k•9L••n.*k.ft.tt..}?•R'):
' *},::::•.,.:fi,.:r,sr. 456-3604 E ts:-fir•Pi ct'r.j{..A.*.j,..n.
ty J1 . 11J / *1 ? k ;! fii* : nFR rjJsx? THANK Y . . . :3 .. : . . „ r. *
; jfii _ja *! : *i :9 1 f : *j •