1991, 05-15 Permit: 91002586 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 Sokane 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 provisio„ 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 fd any subsequent inspection approvals or Certificates of Occupancy shall not be construed to
give authority to violate or cancel the provisions of any stet, r local ulating construction,or as a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF ' /
APPLICATION _ (7/7
OWNER OR AGENT DATE
PROJECT NUMBER= 9i002586 ISSUED PERMIT DATE= 05/15/91 PAGE= 01
**************************** PERMIT INFORMATION ****************************
SITE STREET= iiii5 E 29TH AVE PARCEL4= 28543-42ii
ADDRESS= SPOKANE WA 99206
PERMIT USE= SEWER CONNECTION - SOUTH KOKOMO
*** SEE NOTE ***
PLAT4= 001393 PLAT NAME= KOKOMO TOWN%ITE
BLOCK= 42 LOT= ZONE= AG%UB DI%T4=
AREA= 00060000 F/A= F WIDTH= DEPTH= R/W=
4 OF BLDG%= 1 4 DWELLINGS= i WATER DIST =
OWNER= GREEN, WAYNE D PHONE= 509 928 0896
STREET= iiii5 E 29TH AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= WAYNE GREEN PHONE NUMBER= 509 928 0896
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** %EWER PERMIT ******************************
CONTRACTOR= OWNER PHONE=
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- --------
PROCESSING FEE FEE Y 10. 00
SEWER CONNECTION i 40.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
05/i5/91 2894 50. 00
TOTAL DUE=DUE= .00 TOTAL PAID= 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------ -------------
%EWER PERMIT 50.00 50.00 .08
------------- ------------50,00 50,00 5O.O8 .00
PROCESSED BY : JULIE %HATTO
PRINTED BY : JOHN LARSON
SEWER STUB A%-BUILT INFORMATION IS AVAILABLE 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 CABLES, GAS PIPINGWATER iINE%, ECT .
CALL BEFORE YOU DIG (45 ' '-8000)
SEWER STUBS RE TO BE CHECKED PRIOR TO CONNECTION TO INSURE
THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN
********* CALL FOR INSPECTION PRIOR TO COVER **********
********* 24 HOUR NOTICE REQUIRED **********
********* 456-3604 **********
******************************** THANK YOU *********************************
SPECIAL CONDITION CHECKLIST
Project
Address: Project#_ Use: _.
Dept: Date: Condition: Init: Appr:
(in) (out)
Dept.of Bldgs.
Special Insp.Final Report_ —
Hydrant( )
Lock Box
Engineer's _ RID/CRP,
Easements
Road Plans/Improvements_
Bonds
Plannin _ Bonds. — — _
Utili