2004, 09-01 Permit: PO406104 Meter • EWII /� '�.r.n DEPARTMENT OF
ark-AVIINLE ENGINEERING SERVICES
pp go ak 1 808SPOKANEW.SPOKANE
WASHINGTOFALLSN BLVD.
, 99201-3343
(509) 625-6700
FAX (509) 625-6349/(509)625-6124
til) www.spokan*ngin*ring.org
*** METER PERMI �'kk
Applicant: CONTRACTOR:
LINDSEY CONSTRUCTION INC LINDSEY CONSTRUCTION INC
P 0 BOX 30792 P 0 BOX 30792
SPOKANE WA 99223 SPOKANE WA 99223
Phone: 509 879 3420 Phone: 509 879 3420
PERMIT NO: P0406104 Issued: 09/01/04
Project No: *0308037 Validated by: CAR
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: 4724 E 13TH AVE Acct # 103555/S105057
St. Width: 100 No. of Units: 1
Parcel No: Inside City? 0 Acct Type: RE
Legal Desc:
Tap Size: 1"
Sewer Sys;Water Sys; Zip 1 ; E ; 99212
Meter Size - Meter Code: 1" - 03
Installed In (bsmt,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 (pressure over 80 lbs.) ? Y/N Y
Was Annexation Covenant Signed? NA
TOTAL COSTS 505.00
Method Check # Receipt No. Date Payment
CK 211 P4#04867 09/01/04 505.00
TOTAL THIS DATE ********* 505.00