1991, 10-02 Permit: 91005476 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 withvmommmn In additionI 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 NUM;:.iEk= 91005476 DATE= i0/02/91 F'AF= /)i
**************************** PERMIT INFORMATION ****************************
SITE %TREET= 10915 E 28TH AVE PA�C�L�= 28543-3�O4
ADDRE% = %PGKANE WA 99206
PERMIT U%E= SEWER CONNECTION — %OUTH KOKOMO
***
EEE NOTE ***
PATO- 001393 PLAT NAME= KOKOMO TOWN%ITE
B—OCK= 38 LOT= ZONE= AC%UB DI%T4=
AREA= 00000000 F/A= F WIDTH= DEF:,TH=
4 OF BLDG%= 1 :!!, DWE1.1 i WATER DIET =
OWNER= HOYT PHONE=
%TREET= 109i5 E 28TH AVE
ADDRE%%= SPOKANE WA 99206
C�)�TACT NAME= DONNA COURCHAINE PHONE NUMBER= 509 924 �4�5
BUILDIN� %ETBACKFRONT= NA LEFT= NA RIGHT= NA REAR= NA
**** *********** *** **** **
CONTRACTOR= COURCmAINE CON%TRUCTION PHONE= 509 924 5495
STREET= 16402 E VALLEYWAY
ADDRE = YERADALE WA 99037
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- ----------
PROCE%%IN� FEE Y
10 , 00
%EWER CONNECTION
*** *** ** *********** ***** PAYMENT %UMMARY ************************»**x
PAYMENT DATE RECEIPT4 PAYMENT AMGUNT
10/02/91 7241 50. 00
------------
TOTAL DUE= .00 TOTAL PAID- 50 . 00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWINC.:,
-- ------------ ------------- ------------ _____________
EEWER PERMIT 5O . 00 50 .00 . 3O
------------- ------------
.
50 , 00 50 . 00 . 00
PRGCE%%ED BY .|ULIE %HATTS
PRINTED BY : JULIE %HATTO
�EWER %TUB A%—BUILT INFORMATION I% AVAILABLE AT THE �OV�TY
UTILITIES DEPARTMENT ( 456-3604)
CONTRACTOR OR APPLICANT I% TO FIELD iOCATF AND CONFI�M THF
ELEVATION AND PO%ITION GF %EWFR %TUG PRIOR TG ANY ;T�FR
EXCAVATION
TO LOCATE PIPINc5 , WATER ilNE% , F�r .
'
CALL BEFORE YOU DIG ( 45 -8O0O)
%EWER
MUD::, ARE TO BE CHECKED PRIOR TO CONNECTION TO I*�UPF
THAT THEY ARE CLEAP AND MAIN
********* CALL FOR INSPECTION PRIOR TO C;vEP **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 **********
******************************** THANK YOU *********************************