1990, 08-17 Permit App: 90004012 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
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,oras a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
DATE= I.l i:t f -{ }I` r?'1 PAGE= ;5'�
•.
APPLICATION
ICAT•rON
)t-*gl*74•***f+::+l•1?'1i'fit*ti•:}t'i s+ ?}..j+.1{..:t.*}.*i,,**.J..tt. APPLICATION 3 ?'*It*J'ti'*:e:)`)i•)?•*3'.'1?•7L•? **)?-.k.:J.*.jf.?,.**•jk*:..u,_j}..j,.
, [ L. STREET= 12812 i .u.._
,.:.1. 1 .... L: "I'L.I {a5 } " 22542-244
ADDRESS= EPOKANE WA 99206
PERMIT
.I I UE}....... :;. }Ii. Ic CONNECTION .... 28I ,
at.yt.p EEE NOTE .
PLAT4= 001692 PLAT NAME= i' }rt..',l...iW :?• ADD
BLOCK= LOT= ZONE= EER DIET4=
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OWNER= I..:rli;.fil.U EK f•`1 !.T RHONE=
STREET= 12.8i2 r 6TH AVE
`;t;j't.:jE<I: ti';°:::: SPOKANE WA 99206
CONTACT NAME= LEONARD .... H !ro - {9,:; ,:.4
BUILDING :•L i };tits •t, . : FRONT= LEFT= RIGHT= .1 REAR=NUMBER= :2R
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,.;ttit,i.^ C:.ET:�: 11817 E .rfI...±.._C:::'($'tr` AVE
{^t 1_JDR1::.4,.S:.. SPOI<.ANI::. 4A 99206
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ITEM DESCRIPTION QUANTITY mouN
PROCESEING FEE 10„00
SEWER CONNECTION ; 4A, i•J!;!
PERMIT TYPE i'1...... AMOUNT 1 AM1..1t.li•1 ! PAID AMOUNT OWING
EEWER PERMIT 50,00 .00 150,00
PROCEEEED BY : JULIE SHATTO
PRINTED BY : ._1?.J f....t.e... :.4 F';AI t L.?
,.r,...=!:_..:.R ::: } U AS—BUILT INFORMATION . �3 AVAILABLE AT THE COUNTY
UTILITIES i;j j;"1r.:Iii R: } r•E 1'N T (456-3604)
CONTRACTOR t11'4 APPLICANT IE TO FIELD L.c:tc::ATE AND CONFIRM HF
ELEVATION ExcAVA_I}_)N ANDPOSITION OF ...SEWER ,SiT?.IT PRIOR .#isf ANY OTHER
IoN
TO LOCATE BURIED C:t}r,I...ESG A=}'t•' PIPING, .!I 1i is '•!I. ,.,i ECT ,
CALL i. BE FOR+.. YOU} c�5 t.
+
EWER :Siis?.i.i:{:4! ARE It.} .: E CHECKED FR.1.OB TO CONNECTION TO INSURE
I HA i THEY ARE CLEAR AND UNOBSTRUCTED TO i HE EEWER MAIN
.P.•i+:.jt..3...A 74'.P..jl* CALL 'O R INSPECTION PRIOR TO COVER A P:')+:'P::+1:'A:7l•'P il"P
�.i.)r a>•f;....}:2:•:n• :,�;- HOUR NOTICE REQUIRED .. ......
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