1991, 06-18 Permit: 91003137 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509)456-3675
1 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= R=- 5'i0003t ISSUED PELF MIT DATE= 0608/91 PAGE= Oi
PERMIT INFORMATION
SITE STREET= 10723 E:: 25TH AVE:: PARCEL`= 28543-2 819
ADDRESS= SPOKANE WA 5'S206
PERMIT USE= SEWER CONNECTION -.. NORTH KOKOMO
** SEE NOTE ***
PLATt= 00:.393 PLAT NAME= KOKOMO TOWNSITE
BLOCK= 28 LOT= ZONE= ACSUB D.r.STO= F
AREA= 00000000 F/A= F" W.T.DThi= DEPTH= R/W== 60
.N OF BLDGS= i 4 PWEL_L..INGE== i WATER DIET
OWNER= SHROPE:: PHONE::---.
STREET= 10723 E 25TH AVE.
ADDRESS= SPOKANE WA 99206
CONTACT NAME= DONNA COURCHAI:NE: PHONE: NUMBER= 509 924 5485
BUILDING SETBACKS: FRONT= NA LEFT= SIA RIGHT= NA REAR= NA
SEWER P ER M I T
CONTRACTOR= COURCHAINE CONSTRUCTION PHONE= 509 924 548
STREET=: 16402 E VALL..EYWAY
ADDRESS= VERADALE WA 99037
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING F"E::E:: Y i o. 0
SEWER CONNECTION i 40.00
PAYMENT SUMMARY
PAYMENT DATE.: RECEIPTy PAYMENT AMOUNT
06/ 18/91
TOTAL. DUE== .00 TOTAL PAID=
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ....._-_. -_. __.._.__-_- ------------ __-_-__-__..-._
SEWER PERMIT 50.00 5000 401.)
------------- ._... --_._...._..1____..___ _.._..______.._._..___
5000 5000 400
PROCESSED BY: JULIE SHATTO
PRINTED D BY : JULIE SHATTO
SEWER STUB AS—BUILT INFORMATION IS AVAILABLE AT THE COUNTY
UTILITIES DEPARTMENT (456--3604)
CONTRACTOR OR APPLICANT IS TO FIELD D L..00ATE: AND CONFIRM THE
ELEVATION FIND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLES, CTAS PIPING, WATER LINES, ECT:.
CALL_ BEFORE YOU DIG (456-80 00)
SEWER STUBS ARE:: TO BE: C:HECKEI) PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
x aux � CALL_ FOR INSPECTION PRIOR TO COVER�►���������
ae�iat ii a� 24 HOUR NOTICE REQUIRED
THANK 'r O t i
Dept: , Date: , Condition_
Engineer's
Plan
Special Insp. Final
Hydrant ( ) _—
Lock Box
Ninety days after C/O issuance:
Owner/contractor called regarding the return of pians: __ �. Date:
Plans returned: -----------__ _— Received by:
No response from owner/contractor - plans destroyed:_------__-____-