1992, 04-03 Permit: 91005259 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,or as a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF J APPLICATION
..
OWNER OR AGENT ./L—�. � DATE
PROJECT NUMBER=
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INFORMATION :}r,a:.ar:..:!;.: :.j.::.:i.:}.:}.:}j.:,j.:.j.' :}j.:l,. :!:.:};:
SITE STREET= 11206 E 21ST AVE PARCFL4= 2'a542- 119
ADDRESS= --.. .•\KANE WA 99206
PERMIT USE= SEWER CONNECTION — NORTH KOKOMO
SEE NOTE *k*
00193
BLOCK= 15 LOT= ZONE= AGSUB DIET4=
_OWNER= RODGERS , DOROTHY RHONE=
ADDRESS= SPOKANE WA 99206
CONTACT NAME= a> !..,,.; Ai`•a i;1':.`.' it.:-t PHONF ti:sm E' .... •• _ ........ .. .
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
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STREET= 115 E TECHIRLEY RD
ADDRESS= SPOKANE FitfdL. .3{.. 99016
ITEM DESCRIPTION QUANTITY AmoUNi
10 , 00
SEWER CONNECTION
40 , 00
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..AT E: RECEIPT4 PAYMENT AMOUNT
04/03/92 2334 50 , 00
................................................
TOTAL DUE- , 00 TOTAL PAID= 50 ,00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
•
SEWER PERMIT 50, 00 50 ,00 , 00
PROCESSED BY . JULIE SHATTO
PRINTED BY : jOHN LARSON
SEWER STUB AS—BuILT *INFORMATION IS AVAILABLE AT THE COUNTY
CONTRACTOR OR APPLICANT IE TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF EEWER ETUB PRIOR TO ANY 07HER
EXCAVATION
Tn .PHRTrn cABLES , GAS PIPING , WATER LINES , ECT ,
CALL BEFORE
1 i t
EEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INEURE
THAT THEY ARE CLEAR UNOBSTRUCTED i! THE SEWER MAIN
'k****K*** CALL FOR INSPECTION PRIOR TO COVER M*:k*:k*****
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