1991, 08-23 Permit: 91004597 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 130$ BROADWAY AVENUE
, SPOKANASHINGTON 99260
( )4�40-3675
I certify that l have examined this permit/application, state that the inform con€Itined 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= 91 00459 7 ISSUED PERMIT DATE= 09/23/91 PAGE== 0 i
***tf•***3E**3E3E*3E3.3E3s3E3E.tt•.0 .u..x..u*•x.aE.3* PERMIT 1NEORM ATI ON ** 3i*#3i•3Eaix*3E3E3f33*3***.3E3E3E3E),**3E3E.3.1E3E
....9
SITE c:.STREET= i .h r .7. t, 5TH f•9 V C 'r ril. � ._.„ .... :_.
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION
3r 3i 3i SEE NOTE:. 3i..x. 3f.
PLATO= 001 669 PLAT NAME= MOORE::' S SURBURBAN HOMES ADD
BLOCK== LOT= ZONE:::::: UR 3,5 DIST:,::::
AREA== 00000000 F/A== f WIDTH= DEPTH= R/W= 50
OF Efl._DGS::= S w 1JL4H...l._IN GS== i WATER DIST =_ 'VERA
OWNER= SMITH, TED
STREET= POB 99669
ADDRESS= SOL_DOTNA, Ai< 99669
CONTACT NAME= CARY BAILEY
BUILDING SETBACKS: E-f't0N1 90
PHONE=:: 509 238 9191
PHONE NUMBER= 509 2:36 9
LEFT=6 RIGHT NA REAR= 49..
PERMIT *********K******************* SL E_I"{ i''f. KIt.T. T 3r##3E}E 3E 3{** *3E 3E 3E iE 3E 3e 3r 343r 3E *3E 3E 3E .3E 3E 3E 3E
CONTRACTOR= UNKNOWN PHONE=
STREI:::T:::: UNKNOWN
ADDRESS= (UNKNOWN WA UNKNOWN
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FEE Y 10.00
SEWER CONNECTION 1 40.00
*3*3*3i9k}E ri3e 3i 34#3i3E3i1i3E*3if#3i*3f3i3ie iF iti31*Je PAYMENT SUMMARY ri"3•)a*)t•)f34)fi*3*3e ie3i •):•)E)E3E)i#>i*:tr3i#:rc.3cyi*
PAYMENT DATE::: RECEIPT PAYMENT AMOUNT
09/23/91 5986 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: JOHN LARSON
PRINTED BY: JOHN LARSON
SEWER STUB AS --BUILT INFORMATION IS AVAILABLEAT THE Ci:JNTY
UTILITIES DEPARTMENT (45.5-3604)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM 1HE:
ELEVATION AND POSITION OF SEWER STt.ili: PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING, WATER :...INES, ECT,
CAL.L. BEFORE YOU DIG (456--8000)
SEWER STUBS ARE:: TO BE: CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO Tiff. SEWER MAIN
3i3E3i3i#3E*** C(1...L...E'OR INSPECTION PRIOR TO COVES( ri#3i3E3i'tE3EH#3E
3E3i3i#3E3 *** 24 HOUR NOTICE REQUIRED 3r3E3Ek3i##3E3E3E
363i3i..A.343i3f3i# 456—'3604 3E1E4E3 3*33i3i5i3E
:A.** 31:.u.3¢}i3E3E3F3E3E#3Fu**)r**3eX. '.13i3f3i* THANK you 3t'3f3Y31313F* 31.3t'3[*343F3f3F3F3F34j43t'Y3l")t"h'R'3r 3t 3: '.4