1992, 11-23 Permit: 92010236 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303$/ROADWAY 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,oras a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PROJECT NUMBER:::: 201 736 ISSUED? PERMIT DA (E:::: 11 "}"ti:'92 PAGE= 01
it t iJ } *Ni *JifiJ ) 9 ! iit r i } iit E " . " „ ? INFORMATION *****3 ******** *** ********'
SITE
STREET= 13104 E 4TH H AVE F'AF°.c,E:.1...+i:_:: 45221 .9186
ADDRESS= SPOKANE WA 99:216
PERMIT USE:::: SEWER CONNECTION ICIN .... SOUTH BLAKE (92S-1170)
*3 f SEE NOTE **
" Fs - 999999 ItT NAME= tFr BLOCK= LOT= ZONE= UNK DISTO=
AREA= e;f4:i{}�;?;yt�}t;0 ' , t..Y:::: #" WIDTH= t,r, r•1._:
:
OF BLDGE= r 0DWEL._i.DWELLINGS= WATER DIST z T =f LiJ�•I•t,.". I...INLf C^ PHONE=STREET= 13104 F 4TH H F i'4j!".
ADDRESS= SPOKANE WA 99216
CONTACT #NA1"?E:::: ALWAYS ACTIVE PHONE NUMBER= 509 922 8.50
BUILDING SETBACKS : FRONT::: N/A LEFT= N/A RIGHT::_ N/A R( AR:::. N/A
N:n it*N:N i{*' it*is N:r a:9t x• ••k•N N:N:• f N:•it a SEWER PERMIT
*N:•N:a N;**k i+:•*Ni it it#••ir-fi.•a••i{•it***N:.j;.};.*Y,.p..i+:*
CONTRACTOR= ALWAYS ACTIVE PHONE= 509 '.P22 ;-t: :....
STREET= PO Bill(, 141562
ADDRESS= SPOKANE WA 99:: 14
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FEE .10.00
SEWER CONNECTION I 40.00
ri*i4 N j{*3f N)e N *N: Ni ii :N:ii N *3t§r x,i bi r PAYMENT ,:U#1MAi cj ar *n 3i** it*it}i h*n x ri u)r*li u it,r it ri**
PAYMENT DATE RECEIPTO PAYMENT AMOUNT
11 /19/92 462 50,00
TOTAL DUE:::: ..00 TOTAL. PAID= 50:,00
PERMIT TYPE FEE AMOUNT AMOUNT PAIS AMOUNT OWING
SEWER PEEtM1. ? 50.00 50.:00 .00
50.00 50.00 .00
PROCESSED BY : DOMITROVICH, ROBIN
PRINTED BY : DOM1ITRC VICH, ROBIN q
SEWER STUB AS—BUILT INFORMATION 1:S; FNVA:i:L..r"YBLI. ft_i. THE COUNTY
UTILITIES DEPAR 1 MENF (456--360'
CONTRACTOR OR APPLICANT ICANT l:S TO FIELD LOCATE r"Yr'Jri CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED f "Lir . , GAS PIPING , WATER LINES, ECT.
CALL GE"tREY O _ EE , (456-8000)
SEWER " Ut : FR 1TO BE CHECKED PRIOR T iCONNECTION # O INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED Ti
THE SEWER MAIN
FOR Et .;.r'�,k C'E:.(.1 1.O i~? PRIOR TO COVER 14•!1•N:•jt•P•N.•N:�:Ni N;
•a:•n.•x••fr h:•xi•x h•ir CALL +
•fr•fr*•r.••,r*•ir* 4 HOUR NOTICE REQUIRED ****it•r.***
•1--it'F'N:'N:•*.i,:N::0.• 456-3604 N:ii•N:N:•ii*•ie a N:N:
•A:*N:•F.•!r•fr it it*ik it 4r)r ik it 1r it!t i!•it it)r•fr R•ir,•,r)r jr 9!•it:+?•i!- THANK Y t-,2 i,f it it it-ik R'Jr•h••,r ik it it R'9r 7r it i!•it:4 A•9`1+'*R-•fr?r 9r:ir or P-•/?-9r 9r•f!•