2004, 06-15 Permit: PO403850 Meter ZO.30t:Jd £TOT+£bb 60S 9P:21 P00? ST Nflf
DEPARTMENT'OF
SPOKANE ENGINEERING SERVICES
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S808WL'OKANN,Wr si�INc nN 9920.1-334.3
(509) 625-6700
FAX (509) 625-6349/(509) 625-6124
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*** METER PE iii ' > ) > ***
Applicant: CONTRACTOR:
LINDSEY CONSTRUCTION INC LINDSEY CONSTRUCTION INC
P O BOX 30792 P 0 BOX 30792
SPOKANE WA 99223 SPOKANE WA 99223
Phone: 509 879 3420 Phone: 509 879 3420
PERMIT NO: P0403850 Issued: 06/15/04
Project No: *0308962 Validated by: DAL
In applying for City water service, I agree:
1. I am bound by City requirements, including those of
Spokane Municipal Code Chapter 13.04 and all terms and
conditions of the Water Rates Resolution, as last
adopted by the Spokane City Council.
2. To arrange for City inspection of the water connection
prior to covering.
3. To pay all charges, including the DEPOSIT. PRICE WILL
BE SUBJECT TO CHANGE, if not installed within one year
from the date this permit was issued.
Signed By:
Connection: DOM
Tap On: 13TH AVE
Between: CUSTER & LLOYD
STREET: 4713 E 13TH AVE Acct #
St. Width: 60 No. of Units: 1
Parcel No: Inside City? 0 Acct Type: RE
Legal Deec:
Tap Size: 1"
Sewer Sys:Water Sys: Zip 1 ; E t 99212
Meter Size - Meter Code: 1" - 03
Installed In (bemt,box) : BSMT
Fee description Units Fee/Unit Ext fee Data
1" Domestic? (Y/N) > 475.00 Y
TOTAL DEPOSIT 475.00
Application Fee? (Y/N) > 30.00 Y
Outside City Connection? (Y/N) . >
N
MUST Customer provide pressure reg-
lator
N
(pressure over 80 lbs.) ? Y/N N
Was Annexation Covenant Signed? Y
00
TOTAL COSTS pa 505.
Method Check # Receipt No. Date Payment
CC 0007 P4#03325 06/15/04 505.00
TOTAL THIS DATE ********* 505.00
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