1996, 10-08 Permit App: 96008760 Double WidePROJECT NUMBER= 96008760 APPLZ'CATION DATE= 10/08/96 PAGE= 01
THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 17208 E COACH DR PARCEL#= 55192.1009
ADDRESS= GREENACRES WA 99016
PERMIT USE= DOUBLE WIDE MANUFACTURED HOME (EXISTING)
PLAT#= 000076 PLAT NAME= APPLE VALLEY ESTATES
BLOCK= 3 LOT= 9 ZONE= UR -7 DIST#= G
AREA= 00000000 F/A= F WIDTH= 70 DEPTH= 120 R/W= 50
# OF BLDGS= 1 # DWELLINGS= 1 WATER DIST =
OWNER= BENTHIEN, LEONARD & LINDA PHONE= 509 922 7433
STREET= 17208 E COACH DR
ADDRESS= GREENACRES WA 99016
CONTACT NAME= LINDA(WORK) PHONE NUMBER= 509 533 8007
BUILDING SETBACKS: FRONT= Jd3df{ LEFT=—UNK RIGHT= UNK REAR= UN -K --
-0
N- --0
****************************** REVIEW INFORMATION *****************************
DEPARTMENT REVIEW REQUIREMENT
BUILDING SETBACK REVIEW REQUIRED
<_
COMMENTS: c `� L -Al")
HEALTHDIST NEW OR ADDITIONAL WASTE WATER
Sewage system designed
COMMENTS : for 3 bedrooms only. Ttno.zci pY 1 Y'r1
�-� Icy%r
C�� a C .f<44 ; c-6`
****************************** MOBILE HOME PERMIT *****************************
CONTRACTOR= OWNER PHONE=
YR/MAKE= 77/TITAN MODEL=
SERIAL#= WIDTH= 24 LENGTH= 65 HEIGHT= 10
ITEM DESCRIPTION
QUANTITY FEE AMOUNT
INSPECTION FEE 2 100.00
STATE SURCHARGE Y 4.50
COUNTY SURCHARGE Y 22.00
PERMIT TYPE
FEE AMOUNT AMOUNT PAID AMOUNT OWING
MANUFACTURED HM 126.50 .00 126.50
126.50
PROCESSED BY: BURRIS, ROBIN
PRINTED BY: BURRIS, ROBIN
.00 126.50
PROJECT NUMBER= 96008760 APPLICATION DATE= 10/08/96 PAGE= 02
******************************** THANK YOU ************************************
p KAN E COUNTY HEALTH DEPARTMENT
E.O.PLOEGER,M.D. ,M.P.H. , Health Officer
Division of Sanitation
N. 810 Jefferson Street
Spokane, Washington 99201
DATF
PERMIT NO / e./g6,
NO A05334
APPLICATION FOR PERMIT TO INSTALL OR RECONSi 4
; SE
Name &1•0/ (--7? 0L�i a1
Address of Proposed Site / -.478 C. C' j�� •
Type of Ilse / - —— !.sement for building planneda
Number of Bedrooms' �.ildi _'Capacity`1 ' 1Camp Capacity Other
Water Supply [eTa� . (fity. W- O .pring). Drywell
Septic tank capacity 2�� 11. sorption
Style of tank
Length of disposal fiel sorptPits .I,,Pach
��_—
(1) Show relative location of: Proposed house. -.ti -ank. '--
disposal field. well. garage and other out gs.
AGE DISPOSAL FACILITIES
S..
LSI
one No. PVA
1' —
•
(2) Make note of any heavy slope or swampy area any
other important topographic details.
/\1215A\ X —P
X
N
r)
Final Inspection Date ///'
Remarks:
CONTRACTOR
FORM 346 REV.HERLTH
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To
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For Spokane County Health Department