1992, 11-05 Permit: 92009810 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 .rocessing. In addition, I have read and understand the INSPECTION REQUIREMENTS/NOTICE
provisions included herein and agree to comply with: 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 thi vv.• application and any subsequent inspection approvals or Certificates of Occupancy shall not be construed to
give authority to violate or cancel the provisio. . z1,7 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 /A 9-
OWNER OR AG ///�/ _ DATE
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ETREET- 12805 E 25TH AVE PARCELO- 45273, 0217
ADDRESE= E?'Ol',;::+?'t?::. WA 99216
PERMIT USE= SEWER CONNECTION HilirRE:::T
PLATO= 001223 PLAT NAME= HILLCREST ACRES 2ND ADD
ARCA= 00014000
is -::- :•� WATER� '
OWNER= VOLGLEMAN, BOB PHONE=
STREET= 12005 E 25TH AVE
ADDRESS= EPOKANE WA 99216
CONTACT NAME= TRIPLE E CONET PHONE NUMBER= 509 927 0256
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i t ,.:! MINTRAnTTNI:, PHONE= 509 927 S256
ETREFT= 11322 E BROADWAY AVE
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ITEM ,.: s
QUANTITY FEE AMOUNT
...l .•1.. ? '•'fit FEE 10, 00
flONNEnTTIIN
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PAYMENT DATE RECEIPTO PAYMENT AMOUNT
11 /05/92 9946 50, 00
................................................
TOTAL DUE= t.,!.t TOTAL
PAID= 50 . 00
1--' .7. 1-1:LE AmuON ! AMOUNT PAID AMOUNT OWING
PROCEEEED BY : DOMITROVICH, ROBIN
PRINTED BY : DOMITROVICH , ROBIN
SEWER ,TUB AE—BUILT . INFORMATION IS AVAILABLETHE
COUNTY
UTILITIES DEPARTMENT
cuNfAcfuR uR AHRLicHN ; TS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
iu LucATE BUkILD CABLE:.,„ r1FING , WATER LINES, ECT.
CALL BEFORE YOU DIG ,:.456-8000)
EEWER STUBS ARE TO cHECKE PHIO INSURE
THAT, ! !
EY ARE ni FAR AND iiNnTiTPHTFT) iHE SEWER MAIN
:!i..rj.:}i.nj.:,j..ij.:1:.:1j.:.1• CALL FOR -I i COVER :u;.t},......ji....:..'t+:24 '..
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HOUR
NOTICE ! i
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THANK :}.:}i.:ti.:!F'i...1!: :li.:`.....t!... .. .. .. .. .. .. .. .. .. ...... ,... .. ..
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