1990, 08-30 Permit App: 90004320 Sewer SPOKANE COT'( 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,or as a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
AT NAM F: OF'F' RI.11'i.t ..1...f; TF F i F's i.. t':. 3! ,3
rI I.:`T.x..:::
_. : . ...
DEPTH= 79% ,J x
= L`.
OWNER= AUBREY . DARRELL L PHONE= 509 '..)24 9129,
ADDRESS= SPOKANE WA 99216
N Mi7..:::: i...i::.i.+!`irt1:»i ...- K PHONE N(.!j•,1z. €:::i't= 9 926 0964
FROlNT:::: NA LEFT= NA f;1(. ...::::
.. i,A REAR= jet<<-
a:;I:n:i**)I:*k•**)L:h}K****•)I:•**it• ••ri*:a•*it•n:n.••si
.
.-.. 509 i i
ITEM i:-1 i DE_Sl::R1.PT.ION QUANTITY 1.44-4:- AmoON
PROCf..
10, 00
SEWER CONNECTION j 40, 00
:" FEE AMOUNT AMOUNT PAID AMOUNT OWING
50 . 00
PROCESSED BY . ..lt.li... .:
SHATTO
.±::�i?::?'. I�llt:i �. `: »'.<t.l.{.?_. ? ,• ii.:°�;{:-.�.�:,-,..� .f• .; .. '{t ?� .,..f. .1.4..i4::' .....1� i`-% i .
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DEPARTMENT. ' 4. w j'i:�—3604)i '
CONTRACTOR
ON..I.Fs :ii:;-•{t::fR O i.;' APPLICANT { FIELD LOCATE : ![ CONFIRM 'T•t"t E
..... .... . . . . ......
"t.1 i]1= SEWER STUB 1=R:F.t:7!•': TO ANY OTHER
TO LOCATE? r-' BURa- _D CABLES, : '1:F'.I.N; WATER t. .T.NF::` , E::t:; - :.
CALL BEFORE YOU t;.).t.Y C.'•i.:%?:;-- 3fifit::i�j
SEWER gTUES ARE .rc.:I BE CHECKED PRIOR I: ..IR.,•, TO CONNECTION ..Li..l INSURE
THAT ' .` ' ARE CLEAR AUNOBSTRUCTED '; THE SEWER ^ ; 4J
{•it3iir.••u'it k: i•3t CALL
; = _ - FOR INSPECTION IFI O. f ' COVER t**** i kn
9
th} . . ,. HOUR . I .
REQUIRED !t••f.-7L•N.**.fr.,..*.r,.
;I:p ti•x.••u•ju:k.�•h: 456--:2:604 iu:•)k ii•n:)u**ai••p )i•
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INFURMATICK WORKSHEET 3Q<IL *
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GENERAL INFORMATICn
e PARCEL NUMBER : /Z-7 L y�55 3 _ *
STREET AC CRE SS : + 1XAIC2) *
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CITY/STATE/ZIP :_c : __2 (2. 4- "
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MAIL INC AUDPCSS :_ % � 1 � QAX-\ N, ---_ *
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CONTACT -'�� C �Cs l� � �, FHCNE :60(].-CM-1C- 11.SETEACKS - FRCNT . LEFT _ RIGHT PEAR �
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PERMIT LSE : \‘ %-_. `�,� \S- 15-CA `N QJ *
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PLUMPING INFCRMATION *
CONTR LIC# : *
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CONTRACTCR : Pt-CNE :____ _ *
MAILING ACCFESS : *
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MEQ-ANICA INFORMATION * 1
CONTR LIC # : .__' S3 . C°- ii
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CON TRACTOR .La:i- . _ Skis c - QN_ Pt-CNE : T - IOV1
MAILING ADCRESS :_k›a �L�\` _ *
ELECTRIC:_ GAS : _ CIL:___ COAL :_ W000: __ SCLAR:___ FEAT FUMP:_ *
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