1992, 07-28 Permit: 92003515 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
VV.1303BROADWAY AVENUE
SPOKANE, WASHINGTON 93260
(509)45G-3075
1 certify that I have exam inedth is permit/application, state that the information contained in it and submitted by me or my agent to compile said permit/application is
and correct, and authorize Spokane County to proceed with processing. In addition, / 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 thatthe issuance ofthis permit/application and any subsequent inspection approvals orCertificates of Occupancyshall not be construed to
give authority to violate orcancel the provisions of any state or local lawregulating construction, or as a warranty of conformance with the provisions ofanystateorlocal
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER onAGENT DATE
PROJECT N�MBER= 920035i5 I%%UED PERMIT DATE= O7/28/92
**************************** PERMIT INFORMATION ****************************
%ITE %TREET= i49O5 E 2i%T AVE PARCEL�= 4526i.2�23
ADDRE%%= VERADALE WA 99O37
PERMIT U%E= %EWER CONNECTION — VERACRE%T (92%-477)
CONVRT PLAT NAME= CONV 1 ED CNTY DAT
B OCK= LOT= ZONE=
AREA= OOOOOOOO F/A= F WIDTH= DEPTH= R/W=
� OF BLDCy%= � DWELLI��%= iO WATER DI%T =
OWNER= �ALVIN, DENI� PHONE=
%TREET= i49O5 E 21%T AVE
ADDRE%%= VERADALE WA 99O37
CONTACT —AMC:ALWAY% ACTIVE — RON %LOAN PHONE NUMBER= 5O9 922 85OO
BUILAC) IN� %ETBACK%� FRONT= N/A LEFA REAR= N/A
***************************** %EWER PERMIT ******************************
CONT TOR= ALWAY ACTI PHONE= 5O9 922 85O�
%TREET= PO BOX 141562
ADDRE%%= %POKANE WA 992i4
ITEM DE%CRIPTION QUANTITY FEE AMOUNT
—.... .... .... .... .... ... .... .... ... .... .... .... .... .... .... .... .... .... .... .... .... .... .... — -------- .... —.... ... --... .... .... ....
PROCIE* %%INFEE Y iO.00
%EWER CONNECTION i 4O.00
******************************* PAYMENT %UMMARY ****************************
PAYMENT DATE
RECEIPT�
PAYMENT AMOUNT
O7/28/92
R35i5
5O.00
.............................................
DUE=
.O0 TOTAL
PAID= 5O.00
PERMIT TYPE FEE
AMOUNT AMOUNT
PAID AHOUNT OWIN�
---------------
%EWER
.... —.... .... —
PERMIT
.... .... .... —.... .... -- ------------
5O.O�
.... .... .... .... .... .... .... .... ... .... .... .... ....
50.0� .00
.... .... —... ....
.... .... .... .... ... .... ... ... ------------
5�.00
... .... ... .... .... .... .... .... .... ... ... .... ....
50.00
PROCE%%ED
BJOMIOVICH,
ROBIN
�RINTED
BYOMITROVICH,
ROBIN
%EWER %TUB A%—BUILT
INFORMATIO�
I% A�AILABLE AT THE COUNTY
UTILITIE% DEPARTMENT (456-36O4)
O TRACT R OR APPLICANT
I% TO FIELD
LOCATE AND CONFIRM THE
ELEVATION AND
1. k. OF %EWER
%TUB P�IOR TO ANY O1 11ER
EXCAVATION
TO LOCATE BURIED
L.- (..'11'. �A% PIPING,
WATER LINE%, ECT.
CALL BEFORE YOU
DIly (45�-8OOO)
...,Al LK %TUB% ARE
TO BE CHECKED PRIOR
TO CONNECTION TOIN%URE
THAT THEY ARE CLEAR AND UNOB%TRUCTED
TO THE %EWER MAIN
********* CALL FOR
IN%PECTION PRIOR
TO COVER **********
********* 24
HOUR OTICE REQUIRED
**********
*********
456-36O4
**********
**** Al, ***************************
THANK YOU
*********************************