2004, 06-23 Permit: PO404159 Sewer JUN-23-2004 WED 09:59 AM FAX NO. P. 01
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SEWER PERMIT
Applicant
JOHN D STICKELMEYER
3624 S MT VERNON
SPOKANE WA 90223
Phone: 230-6887 Phone:
Issued: 06/23/04
PERMIT NO: p0404159 Completed:
CoAppro : BL Project No: *0310060
Approvaall
Applicant hereby consents and agrees:
1. To adhere to all rules and regulations in accordance
with Title 13 .03 Spokane Municipal Code, City of Spokane
REMARKS:
___. Inspector
Lz.i :}?cetion area: 4 Validated by: CAR
Proj1 /Prof#: 13TH A(2)2 23-25-43 2002110 EL
Sewer Name: 13TH AVE
STREET: 4717 E 13TH AVE
Right of Way: D Easement: 1
Parcel Not
Logal. Dcsc:
uY-Tap”: '
ENTERS PROPERTY:
, Depth/Pipe Size & Type: /
ENTERS BUILDING:
Connection to Cess Pipe: /
Depth/Pipe Size & Type:
Yea description Units Fee/Unit Ext fee Data
30.00 Y
Application Fee? (Y/N) > 50.00 Y
inspection Fee? (Y/N)
> GFC
ERU surcharge (Input Amount) > y
Was Annexation Covenant Signed? 50.00
SubtoLal Inspections: 50.00
Total Fees
Method Check it Receipt No. Date Payment
06/23/04 80.00
P4#03527
CC 0004 ********* 80.00
TOTAL THIS DATE;
JUN 23 2004 10 30PAGE.01 _--~