2004, 12-10 Permit: P0409065 Meter b0'30dd 2TOT £bb 60S FO: 'T 1700Z 0T 03a
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*** METER PER IT ***
Applicant: CONTRACTOR:
LINDSEY CONSTRUCTION INC LINDSEY CONSTRUCTION INC
P 0 SOX 30792 P 0 BOX 30792
SPOKANE WA 99223 SPOKANE WA 99223
Phone: 509 879 3420 Phone: 509 879 3420
PERMIT NO: P0409065 Issued: 12/10/04
Project No: *0011806 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: 14TH
Between: CUSTER & CHRONICLE
STREET: 4725 E 14TH AVE YA Acct #
St. Width: 60 No. of Units: 1
Parcel No: Inside City? I Acct Type: RE
Legal Desc:
Tap Size: 1"
Sewer Sys;Water Sys; Zip 1 ; A ; 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- N
lator (pressure over 80 lbs.) ? YIN Y
Was Annexation Covenant Signed? 505.00
TOTAL COSTS
Method Check # Receipt No. Date Payment
CC 0004 P4#07249 12/10/04 505.00
TOTAL THIS DATE 505.00
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