1990, 09-17 Permit App: 90004645 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,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= 90004645
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SITE STREET= 12410 E 12TH AvF I::: 2
i••'! .•!t-R i::. 'o-,:}:::: SPOKANE WA 99216
PERMIT USE,.. SEWER CONNECTION — 2e01
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OWNER= KOSANKE , ARTHUR
i -{.I:.!::. ! :::: 12410 f::. •1 , E..I AVE
ADDRESS= _1 • -•...'N SPOKANE 99216
CONTACT NAME= GOBERS PHONE NUMBER= 509 924 577'2,
}:::.? ; 1...h?.I.N G SETBACKS : -" NA LEFT= NA F•t .:.i.G. . .
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ETREET= E TRENT AVE
ADDRESS= SPOKANE WA 99206
•
ITEM DESCRIPTION QUANTTTY
•
ERPUSEING FE 10,00
.).1::.IAER ._`•-•.tN1-y1".t..•I•.1.t.i I`a ai i-1 : ih t7
_ C , , . F TYPE
y • . tEE {
'O1! • AMOUNT
PAID Af`" ';%.i:}..3_ OWING
SEWER PERMIT 50A00 ,00 50,00
50„OO ,00 50,00
PROCESSED ,
PRINTED BY : JULIE ,...•r t I ...
SEWER.
STUB \c . INFORMATION . AVAILABLE A_ iEI -
I `
UTILITIES DEPARTMENT ( 456-3604)
CONTRACTOR OR POSITION
,., ..{.i, (.., i' , I i t PRIOR
t :..I... I::•I:
1 FIFL LOCATE AND
ELEVATION (..:<•�:• !.�i b.i, t !, -'`•< L.1 t::! ,.. .... I
TO •y .i' {i..I:: GAS PIPING, Ni
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CALL BEFORE YOU DIG ( 456—S000)
EEWER
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BF .`.1 PRIOR t t i•• 1'�S`-1 .` i "a`a,. ,,. ...
THAT THEY E.ac.<.. CLEARE ARE AND�, i.y! t.. I t !!I THE+ !-,Es+. -
IN
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:,i.:!C:o-;kat-:t::4t:9t•1t• t1L
f 1 v. .iI PRIOR COVER.
44 HOUR NOTICE REQUIRED
*)t'RY }.r ! }
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JOB ADDRESS: [� ! t f� T 2- I
SUBDIVISION: _r
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APTKUK PHONEOWNER: 2 KSS
ADDRESS: _� � f �
PHONE:1 �(
CONTRACTOR: (-2:-.Cn'ER � ���
ADDRESS: 11D1 '�
LICENSE #: 6
INSPECTION DATE:
TYPE OF OCCUPANCY: