1992, 04-10 Permit: 92001890 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 APPLICATION
OWNER OR AGENT DATE
PROJECT NUMBER== 92001890 ISSUED PERMIT DATE= 04/10/92 PAGE= 01
**************************** PERMIT T INFORMATION ******3 ***** **************
SITE STREET= 15020 E 21ST AVE PARCEL4= 26541 -2105
ADDRESS:::: VERADALE WA 99037
PERMIT USE= SEWER CONNECTION -• V RAC;F?F::ST (92S-262)
*** SEE NOTE ***
FLAT,= 003136 PLAT NAME= VERA CREST
BLOCK= 3 LUT:- 5 ZONE= SFR DIST: ==
AREA= 00000000 F:A= F WIDTH= DEPTH= l W=:
: OF I:tL.DGS=:: 1 ;: DWELLINGS= 1 WATER DIST =-
OWNER=: GRACZYK , JM PHONE::-
STREET. 15020 I 21ST AVE
ADDRESS= VERADALE WA 99037
CONTACT T NAME* (-I t S CONSTRUCTION PHONE NUMBER=R== 509 9:2 'a `s9 64
BUILDING SETBACKS : FRONT= N/A LEFT= N/A RIGHT= N/A REAR=:: N/A
*******•*** ***** •****••** **•x SEWER PER iIT *R•* :•*• ** • :• :•* :•:•;i••p:*•;t•x••;;:* :b:•;>:••i::***•x:
CONTRACTOR= H t S CONSTRUCTION PHONE= 509 926 8964
STREET== 11817 E VALLEYWAY A a E
ADDRESS= SPOKANE WA 99206
ITEM DESCRIPTION QUANTITY FEE AMOUNT
---
PROCESSING FEE Y 10.00
SEWER CONNECTION .I 40.00
*************** •**x************ PAYMENT SUMMARY ** :****3(****'..M..h** 'P•**M•*•!t••>***
PAYMENT DATE. RECEIPT : PAYMENT AMOUNT
04/10/92 2555 50.:00
------------
TOTAL. DUE= .00 TOTAL PAID== 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
SEWER PERMIT 50.00 50.00 ,00
•
50.00 50.. je ,00
PROCESSED BY : DOMITROVICH, ROBIN
„�
PRINTED BY : DOMITROti.ICH, ROBIN
SF::txIF:R STUB AS—BUILT INFORMATION ].x: AVAILABLE �'t I THE CONT Y
UTILITIES DEPARTMENT (456--3604)
CONTRACTOR AC::TCOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR r:
AiaY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES, ECT
CALL BEFORE. YOU DIG (456-8000)
SEWER STUBS ftR-:. TO BE CHECKED Ix ED rFt]:t.ii TO CONNECTION TO INSURE
E
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
********* CALL FOR INSPECTION PRIOR TO COVER **********
a•******** Shy I.1 ,IUR NOTICE REQUIRED **ii•***.****
**9i *****P !*tkt *) ak* i 9 *i **: ****3THANK y_ 1 *i *9ht*****9Ji * t*
***ij *j **** r***P