1991, 04-11 Permit: 91001114 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDINGS
^ .
W. 1303 BROADWAY AVENUE
SPOKANE,WASHINGTON 99260
(509)456-3675
/oemfymat/huvooxummoum/,perm/uannooauon.mammanxomm,mat/vnuontamemmnanuouummeu»vmoonnvagenn000mpnooumpermit/application is true
and correct, and authorize Sx County to proceed with processing. In addition, I have read and understandtme 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= 91001114 ISSUED PERMIT DATE= 04/11 /91 PAGE= 01
**************************** PERMIT INFORMATION ****************************
SITE STREET= 15204 E 24TH AVE PARCEL4= 26544-1705
ADDRESS= VERADALE WA 99037
PERMIT USE= SEWER CONNECTION - DISHMAN-MICA INTERCEPTOR PKG 44
*** SEE NOTE ***
PLAT4= 001 593 PLAT NAME= MCLAUGHLIN ADD
BLOCK= i LOT= 5 ZONE= AGRI DI%T4= F
AREA= 00000000 F/A= F WIDTH= DEPTH= R/W= 60
4 OF BLDGS= i 0 DWELLINGS= i WATER DIET =
OWNER= KELLEY PHONE=
STREET= 15204 E 24TH AVE
ADDRESS= VERADALE WA 99037
CONTACT NAME= TERRY COURCHAINE PHONE NUMBER= 509 927 6760
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** SEWER PERMIT ******************************
CONTRACTOR= TLC CONSTRUCTION PHONE= 509 927 6760
STREET= 13816 E 12TH AVE
ADDRESS= SPOKANE WA 99216
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- --------
PROCESSING FEE Y iO.00
SEWER CONNECTION 1 40.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
04/11 /91 1979 50.00
------
TOTAL 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 .00
PROCESSED BY : JULIE SHATTO
PRINTED BY : JULIE SHATTO
SEWER STUB A%-BUILT INFORMATION ISAVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLESGAS PIPING, WATER LINES, ECT.
CALL BEFORE YOU DIG (45l
-8OOO>
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR N %T D TO THE SEWER MAIN
********* CALL FOR INSPECTION PRIQR TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 **********
******************************** THANK YOU *********************************
SPECIAL CONDITIONCHECKLIST
Project
Address: Project# — Use;
Dept: Date: Condition: !nit: Appr:
(in) (out)
Dept.of Bldgs.
Special Insp.Final Report
Hydrant( )
Lock Box
, !
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Enasneer's �_ RID/CRP---
Road Plans/Improvements
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"." THIS SPACE FOR COMMERCIAL PLANS;TRACKING,_+w-ERT!EtCATEO:FOCQ.€lf),ANC?'ONI.Y:;•»"•"•
_. __
Date received for C/O processing:; , : w w ii t Plens' rtsf&ed::Pxsr final prod;-sing H
Temporary CIO issued• -it:ai -' • TSF C e'•rt-ifI9�a�of acc uparcy.issue :' n r t
Office file review by,slf_ ... 1__ __. _._ _-----._- ____.__._ - Date: _ ...
Ninety days after C70 issuance:
Owner/contractor called regarding the return of plans. — —_ Date
Plans returned: ___._ Received by:
No response from owner3'contractor-plans destroyed:_--_-- —__---