1992, 04-16 Permit: 91005366 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON SB260
(509) 456-3675
| certify that | have examined this pmmivunonovnon.state that the information contained initand submitted uvm°onnyagent mcompile said permit/application /atmo
u correct, and authorize Spokane County to proceed withnmvossmo In addition, / 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 ofthis 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= 9iOO5366 I%%UED PERMIT DATE= O4/i6/92 PA�E= Oi
**************************** PERMIT INFORMATION ****************************
%ITE %TREET=
iO8O4 E 3i%T AVE
PARCEL�=
28543-5332
ADDRE%%=
%POKANE WA 99206
PERMIT �%E=
%EWER CONNECTION —
%OUTH Klie. OMO
*** %EE NOTE ***
93 PLAT N E=
KOKOM T WN%ITE
BLOCK=
53 LOT=
ZONE= UNK
DI%T�= F
AREA=
OOOOOOOO F/A=
F WIDTH=
DEPTH= R/�=
0)
� OF BLD�%=
i � DWELLIN�%=
i WATER I.)
=
OWNER=
RA LER
PHONE=
%TREET=
i08O4 E -Z '37 AVE
ADDRE%%=
OK WA �92O6
%PANE'.
CONTACT NAME=
%TAN ANDERTON
PHONE
NUMBER= 5O9 922 4594
BUILDIN� %ETBACK%�
FRONT= NA LEFT=
NA RIYHT= NA
REAR= NA
*****************************
E. WE.
PERMIT ********
ii. *********************
CONT =iti P LL j % C % TION
JTREET= ii5 % T%CHIRLEY RD
ADDRE%%= %POKANE WA 99216
ITEM DE%CRIPTION
-------------------------
PROCE%%ING' FEE
JEWER CONNECTION
PHONE= 5O9 922 4594
QUANTITY FEE AMOUNT
-------- .... .... .... .... .... .... ... .... .... —
Y iO.00
1 4O.00
******************************* PAYMENT %UMMARY ****************************
PAYMENT DATE RECEIPT� PAYMENT AMOUNT
04/i6/92 2792 5O
.00
------------
TOTAL DUE= .00 TOTAL PAID= 50.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWIN�
--------------- .... .... .... —.... .... —... .... —.... .... .... ------------ ... .... —.... .... .... .... .... .... —.... ... —
%EWER PERMIT 5O.00 5O.00 .00
------------- ------------ ... .... .... .... ... ... ... .... ... .... .... ... ...
50.00 50.00 .00
PROCE%%ED BY� JULIE %HATTO
PRINTED 1,.iYDOMITROVICH, ROBIN
%EWER %TUB A%—BUILT INFORMATION I% AVAILABLE AT THE COUNTY
UTILITIE% DEF:ARTiv, ENT (456-36O4)
T ACT R OR APPLICANT I% TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND PO%ITION OF %EWER %TUB PRIOR TO ANY OTHER
EXCAVATION
TO LOCATE BURIED CABLE%� �A% PIPINr, WATER LINE%, ECT.
CALL BEFORE YOU DI(1(45�-8OOO}
%EWER JTUBJ ARE TO BE CHECKE PRIOR .... CONNECTION TO IN%URE
THAT THEY ARE CLEAR AND UNOBJTRUCTED TO THE %EWER MAIN
********* CALL FOR IN%PE ION PRIOR TO COVER **********
********* 24 .OUR NOTICE REQUIRED **********
********* 456-3604 *********if.
********** if. **** ii- **************** THANK YOU *********************************