1992, 04-13 Permit: 92001719 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 »moossmn In additionI have reaand 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,or as a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PROJECT NUMBER= 92001719 ISSUED PERMIT DATE= 04/13/92 PAGE= 01
**************************** PERMIT INFORMATION *********************** * *
SITE STREET= 10716 E 21 %T AVE PARCELO= 28542-29O5
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION - 90-01 - (92%-232)
*** SEE NOTE ***
PLATO= 001393 PLAT NAME= KOKOMO TOWN%ITE
BLOCK= 13 LOT= 9010 ZONE= UR-3.5 DI%TO=
AREA= F/A= F WIDTH= DEPTH= R/W=
0 OF BLuGS= 4 DWELLINGS= i WATER DIET =
OWNER= JACKSON, DEAN A PHONE=
STREET= 10716 E 21 %T AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= FORDS CONSTRUCTION PHONE NUMBER= 509 924 6182
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** %EWER PERMIT ******************************
CONTRACTOR= FORDS CONSTRUCTION PHONE= 509 924 6182
STREET= 9713 E 4TH AVE
ADDRESS= SPOKANE WA 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- --------
PROCESSING FEE FEE Y 10,00
SEWER CONNECTION i 40 .00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPTO PAYMENT AMOUNT
04/13/92 2630 50.00
TOTAL DUE=DUE= .00 TOTAL PAID= 50 .00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------
SEWER PERMIT PERMIT 50.00 50.00 .00
------------- ------------
50.00 50.00 5O.00 .00
PROCESSED BY WENDEL GLORIA
PRINTED BY � DOMITR�VICH, ROBIN
SEWERSTUB A%-BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT I% 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 (45 -8 OO)
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 *********************************