1991, 10-02 Permit: 91004090 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUESPOKANE,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 understandm 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= 91004090 ISSUED PERMIT DATE= 10/02/91 PAGE= Oi
**************************** PERMIT INFORMATION ****************************
%ITE %TREET= 10522 E 28TH AVE PARCEL0= 29544-0604
ADDRE%%= SPOKANE WA 99206
PERMIT U%E= %EWER CONNECTION - SOUTH KOKOMO
*** SEE NOTE ***
PLAT0= 000376 PLAT NAME= CHESTER HILLS HEIGHT%
BLOCK= i LOT= 4 ZONE= UR 3.5 DI%T4=
AREA= OOOOOOOO F7A= F WIDTH= DEPTH= R/W=
4 OF BLD.~ ~= i 0 DWELLINGS= i WATER DIET =
OWNER= MARTIN PHONE=
, OWNER= 10522 E 28TH AVE
ADDRE%%= %POKANE WA 99206
CONTACT NAME= STAN ANDERTON PHONE NUMBER= 509 922 4594
BUILDING %ETBACK% : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** %EWER PERMIT ******************************
CONTRACTOR= A PLU% CON%TRUCTION PHONE= 509 922 4594
%TREET= PO BOX 141557
ADDRE%%= SPOKANE WA 992i4
3 ITEM DE%CRIPTION QUANTITY FEE AMOUNT
� ------------------------- -------- ----------
PROCEING FEE Y 10,00
%EWER CONNECTION 1 40.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPTO PAYMENT AMOUNT
10/02/91 7237 50.00
------------
TOTAL DUE= .00 TOTAL PAID= 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
� --------------- ------------- ------------ -------------
SEWER PERMIT 5O.00 50.00
� ------------- ------------ ------------- �
50.00 50.00 .00
PROCESSED BY : JULIE %HATTO
PRINTED BY : JULIE %HATTO
SEWER STUB A%-BUILT INFORMATION I% AVAILABLE AT THE COUNTY
UTILITIE% DEPARTMENT (456-3604>
CONTRACTOR OR APPLICANT I% TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER
EXCAVATION
�-
TO LOCATE BURIED CABLES, GAS PIPING , WATER LINES, ECT.
CALL BEFORE YOU DIG ( 45"-8O0O)
SEWER STUBS RE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBETRUCTED TO THESEWER MAIN
********* CALL FOR INSPECiION PRIOR TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 **********
* ****************** *********** THANK YOU ****************** *********** *