1992, 04-20 Permit: 92001943 SewerSPOKANE 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= 92001943
ISSUED PERMIT DATE= 04/20/92 PAGE= 01
**************************** PERMIT INFORMATION ****************************
SITE STREET= 13204 E 5TH AVE PARCEL,'.•= 22541-9067
ADDRESS= SPOKANE WA 99216
PERMIT USE= SEWER CONNECTION - SOUTH BLAKE (92S-277)
*** SEE NOTE ***
PLATO= 999999 PLAT NAME= RANGE
BLOCK= LOT= ZONE= AGRI DIST:= F
AREA= F/A= F WIDTH= DEPTH= R/W= 50
OF BLDGS= 1 t DWELLINGS= 1 WATER DIST =
OWNER= ROSGEN DIANE PHONE=
STREET= 13204 E 5TH AVE
ADDRESS= SPOKANE WA 99216
_CONTACT NAME= SIMPSON SANITAITON PHONE NUMBER= 509 926 4781
BUILDING SETBACKS: FRONT= N/A LEFT= N/A RIGHT= N/A REAR= N/A
***************************** SEWER PERMIT ******************************
CONTRACTOR= SIMPSON SANITATION
STREET= 7812 E BALDWIN AVE
ADDRESS= SPOKANE WA 99212
ITEM DESCRIPTION
PHONE= 509 926 4785
QUANTITY FEE AMOUNT
PROCESSING FEE Y 10.00
SEWER CONNECTION 1 40.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT: PAYMENT AMOUNT
04/20/92 2867 50.00
TOTAL DUE= .00 TOTAL PAID= 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
SEWER PERMIT 50.00
50.00 .00
50.00 50.00 .00
PROCESSED BY: DOMITROVICH, ROBIN
PRINTED BY: DOMITROVICH, ROBIN
SEWER STUB AS -BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES, 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 *********************************