2003, 09-17 Permit: PO305468 Tap }
DEPARTMENT OF
SPOKANE ENGINEERING SERVICES
fl 808 W SPOKANE FALLS BLVD.
SPOKANE,WASHINGTON 99201-3343
(509) 625-6300
FAX(509)625-6349/(509)625-6124
www.spokaneengineering.org
*** TAP PER ***
JOHN T. POWERS,JR.
MAYOR
Applicant: CONTRACTOR:
MDS SHULER INC MDS SHULER INC
5813 E 4TH AVE SUITE 102 5813 E 4TH AVE SUITE 102
SPOKANE WA 99212 SPOKANE WA 99212
Phone: 462-3027 Phone: 462-3027
PERMIT NO: P0305468 Issued: 09/17/03
Project No: *0308966 Validated by: SLH
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: 4718 E 13TH AVE Acct #
St. Width: 100 No. of Units: 1
Parcel No: Inside City? 0 Acct Type: RE
Legal Desc:
Main Size and Type: 8"
Tap Size: 1"
Sewer Sys; Water Sys;Zip 1 ; E ; 99212
Fee description Units Fee/Unit Ext fee Data
Application Fee? (Y/N) > 30.00 Y
Outside City Connection? (Y/N) . >
Was Annexation Covenant Signed? NA
1" Tap? (Y/N) > 310.00 Y
TOTAL DEPOSIT > 310.00
TOTAL AMOUNT DUE 340.00
Method Check # Receipt No. Date Payment
CK 3959 P3#05541 09/17/03 310 .00
CK 3959 P3#05565 09/18/03 30.00
TOTAL THIS DATE ********* 30.00