1990, 04-03 Permit App: 90001252 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
W. 1303 BROADWAY AVENUE
SPOKANE,WASHINGTON 99260
(509)456-3675
I certify that I have examined this permit/application,state that the information contained in it and submitted by me or my agent to compile said permit/application is true
and correct, and authorize Spokane County to proceed with processing. In addition, I have read and understand the INSPECTION REQUIREMENTS/NOTICE
provisions included herein and agree to comply with same.All provisions of laws and ordinances governing this type of work will be complied with whether specified
herein or not.I understand that the issuance of this permit/application and any subsequent inspection approvals or Certificates of Occupancy shall not be construed to
give authority to violate or cancel the provisions of any state or local law regulating construction,oras a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
• PROJECT NUMBER= 90001252 DATE= 04/03/90 PAGE= 01
APPLICATION
****************************** APPLICATION *********************************
SITE STREET= 5704 E 15TH AVE PARCEL..4= 23534-1001
ADDRESS= SPOKANE WA 99212
PERMIT USE= SEWER CONNECTION •••• SLOAN' S ADDITION
*** SEE NOTE ***
PLATO= 002396 PLAT NAME= SLOAN' S ADD
BLOCK= 2 LOT= 1 ZONE= SFR DIST4= E
AREA= 00000000 F/A= F WIDTH= 103 DEPTH= 136 R/W=
4 OF BLDGS= 4 DWELLINGS= 1
OWNER= LUNDSTROM TOM PHONE= 509 534 2657
STREET= 5704 F 15TH AVE
ADDRESS= SPOKANE WA 99212
CONTACT NAME= TOM LUNDSTROM PHONE NUMBER= 509 534 2657
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** SEWER PERMIT ******************************
CONTRACTOR= OWNER PHONE=
ITEM DESCRIPTION (QUANTITY FEE AMOUNT
��w
_
PROCESSING FEE Y_._____.. -- 10.00
SEWER CONNECTION 1 40,00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
...._..
50.00 __ ._......00 «...._.........._..__..50.00
PROCESSED BY : JULIE SHATTO
PRINTED BY : JULIE SHATTO
SEWER STUB AS-BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE. AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES, ECT.
CALL BEFORE YOU DIG (456-8000)
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
********* CALL FOR INSPECTION PRIOR TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456--3604 **********
******************************** THANK YOU *********************************