1991, 10-02 Permit: 91005554 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509)456-3675
1 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 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, oras a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
,•Rt.?,il::.t..: ! NUMBER= 0005554 ISSUED PERMIT
DATE=
.:.T•-" 10/02/91 PAGE-
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PERMIT INFORMATION Pi )!j �pi i!!i ii. f,: i},, yr. �;..jt.:,!..ji. it`• jr• �!t �J2• i!t• �J?• �)?• Jk 9ti iG .` •if� �C. �:. .}`r •ki
SITE STREET= i 0 8 t;19 I::. 0ST
A V E P A f't`. t : E::. ?...:t,..... 28543-5206
ADDRESS= SPOKANE WA 99206
PERMIT ±.,-`••E= SEWER CONNECTION E•ION SOUTH H K1. K.OM_j
PLATO= .,!-•.,t,"'`.Y..', PLAT NAME= ?<, ..;?\ t..;;'•ii.,? ' : t.A.!•?,': ? i ?::.
BLOCK= 52 LOT= ZONE= UNK DTSTO=
AREA= 00000000 ... E_ WIDTH= •?= Tji':.;.:jH= R/W7--:
•n" OF ?:3 !. I ! t.r :S .... .! 0 DWELLINGS= •? WATER DIST
....
OWNER= (:' ::,c; NE::'r-,* PHONE:::;
STREET= i0809 E
ADDRESS= SPOKANE WA 99206 .........
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CONTACT NAME= DONNA t.: t.�t.f E''•'.t..P'IA NE::. ."`HONE NUMBER= : 09 .:'.4 ... 'r. ..?
BUILDINGSETBACKS: FRONT= = NA LEFT= NA RIGHT= NA REAR= N}.:",.
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SEWER
vW_R PER;1? .jf• •il:• ai 3ti •j( •j}i §k �Pi 7!• i"i "!tr 3L..jt..j(. .j,..jj..p:.jr..,¢ .!:..,;. :lt:• 9ti "jti i!!r §>." 3t: �i!i �Jtr •i+:
CONTRACTOR- COURCHAINE CONSTRUCTION PHONE= 509 .... 548!5'
...
STREET= 16402 E VALLEYWAY
%{?1!:?".I::.,:r,.= b:..R Tt;("1l...E WA 99037
Ii...!! DESCRIPTION QUANTITY FEE AMOUNT'
PROCESSING FEE Y
SEWER CONNECTION I 40.0`*�-
E" f••± Y z ±l::. j'H ± SUMMARY
PAYMENT t iA E.. R '.:' 1: E• i PTO PAYMENT AMOUNT
10/02/9i 7241. 5&00
PERMIT TYPE E" E.: E AMOUNT AMOUNT ! e:`t••tID r:{!••SE.,Ii,_I!'••!•?
OWING
SEWER ::: c:' :: '.' ,
t::: .
PROCESSED BY: jULIE SHAT0.''I
PRINTED EY ? E E.tS:
% i_ E
sl::.±?:±_::.."•. STUB AS—BUILT INFORMATION .i.:': AVAILABLE AT THF COUNT`(
UTILITIES DEPARTMENT (456-3604)
CONTRACTOR OR ?•C AP"P"i I[ ,[ •'!N_E IS E ,t t" ILOCATE N , 1CONFIRM _ „ ,.
_
ELEVATION t" T ?`? ?. J POSITION ..+ E- SEWER S i- ;-_ i .; PRIOR t.:± i'`; 'f` i •i H E::. E",,'
EXCAVATION
TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES, ECT,
(456-8000) CALL BEFORE Y t. t E E DIG
:r !, •`•y R7 l., .... 8 0 0 0 .3
SEWER ::: UPS,;. ARE TO BE CHECKED PRIOR TO CONNECTION
TO
.'.N.. I,R.:.
THAT THEY E T A? -GE t.:?...t:.t•"•±R t.:±ND UNOBSTRUCTED TO THE SEWER MAIN
CALL i- E i c INSPECTION PRIOR E r i COVER
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'1t •!!: 9k 3i• ;it• ;n; ??• -J!; : v HOUR NOTICE REQU..R?::.1, ! �J;� it i2" i}i 'Pi i+t' i!t' 'i?• itY ;}f;
456-3604
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