2003, 11-18 Permit: PW03-495 ApproachCall 24 hours before inspection required
Phone 509.688-0036 Fax 509.688-0037
DEPARTMENT OF PUBLIC WORKS
Anticipated start date Permit # PW 3 /i:15
APPROACH PERMIT
APPLICATION
Location of property /S07
(Address/Parcel #, if available)
Applicant Name LIND5aN IJST/20C.T14 lr‘Je
Po Bo -A -301W
Address 5Po rhog 1,04 cietz'3 Phone S-09 43 -7c? 34&
Contractor's Name
Address Phone
Contractor's Reg# Expires
PROJECT DESCRIPTION (Provide site sketch)
Residential Driveway ri Commercial/Industrial Driveway
ri Existing Curb & Gutter ri Rural Road Section
Culvert Installation [l Sidewalk Repair/Construction
riOther conditions
x
See construction requirements and details on reverse. Bond/insurance certification must be on
file with the City.
SPECIAL CONDITIONS:
PERMIT FEE $__Z.5 -
c7
Inspection Fee$
I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card.
Card #
Name ofHolder
Signature
Expiration Date
Fees Paid$ Date
Init