1992, 03-19 Permit: 92001536 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDINGS
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 i NUMBER= 92001536 yvvtirn E.:E, .a, DATE= •92 PAGE= 0
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PARCEL4= 27542-2522
ADDRESS= SPOKANE WA 99216
PERMIT USE= SEWER CONNECTION .... H :.E..,fi...C 1•;[::.:.. (92E-209 )
NOTE
:!:'R'•* SEE N S.i I !;: j.*.}:.
P E..-±.., ! .,,.:.. 001222 PLAT NAME= ' f i E fi'i fi::.r i ACRES 1ST A 1:1
._ :7r
Lut.:I''+.... Lt.? t = a:.ON i::._•' :`:;..t ?) :k 1 N:=
AREA= 00000000 F/A= F WIDTH= DEPTH= R/W=
... : r . .
INGE= WATER DIST =
OWNER= VAN SKIKA PHONE=
ETREET= 12425 9'.
ADDRESS= SPOKANE WA 99216
CONTACT NAME=
ctt . :? E"i
N" EXCAVATION PHONE NUMBER= " i+ 24 5485
BUILDING I "ta tS : FRONT= N/A
LEFT= N;!j::, RIGHT= N ''"" REAR= N/A
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CONTRACTOR= - . Hf . ! t ;! w fi ' i 1ON PHONE= . . . :485
ADDRESS= \I:::.I4(.Ei AL :. :if? 99037
ITEM )t"S'E.r._ I r.::..i.I ON QUANTITY FEE AMOUNT
PROCESSING ::'E:�E: 10,00
SEWER ..,E:::i "ON
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PAYMENT DATE RECEIPTO PAYMENT AMOUNT
03/1 9.•928-±'r'? 50.0
TOTAL! f'\L ?.)E..?t::.' ,00 TOTAL AL fi''f•I).)= 50.00
PERMIT TYPEiEE' : : a ,Etx AMOUNT PAID AMOUNT OWING
SEWER PERMIT 50.00 50.00 .00
50.00 50.00 .00
I-'i O i»:I;;,,t+:S E j S cii i't?. ? ' i..i V.E[:Hi : ROBIN
PRINTED BY : i1ti1"'!. . rt,E-IV;.i-:I»I ROBIN
SEWER STUB AS—BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT .`T.5/... 360x+:
CONTRACTOR OR APPLICANT .E.'. TO FIELD LOCATE AND CONFIRM t? ?•HE
ELEVATION A N f•? POSITION i. . SEWER STUB PRIOR TO A .E+'f' OTHER
EXCAVATION
TO LOCATE a.•:..::'+;-L':. ) .?�:l...E:. GAS PIPING, WATER LINES, ECT,
E.•:f"?t...L B t::. i.?R E YOU U D I is '-t r,....s; t:J!•0 )
SEWER ETUDE !..E!",I::. TO ?:S:::. i_:H F.t:Et•.fi::.?-) i•":{ t.1.?:t E..; t,. ,1' N i"i..• ± a.i.,i E) TO i INSURE
THAT " : ? ARE CLEAR , \ _ UNOBSTRUCTED TO • ISEWERW' ! MAIN
. . j * iP CALL FOR
INSPECTION
±• Ri-OR TO COVER .jt.:p* !'9i..jt'j(.9!.:A:''R.
*i!±::! ii. •i!1?!i*ri :•.t HOUR NOTICE REQUIRED i.EUIRfie.?,j *ii31. 1.**:iiE**
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as *.j..: r ;:. ;**:j: Vi µ }) : : : : y: {: :.,;..::.,.::fj..: : : fTHANK
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