2003, 07-11 Permit: RO03-29 ApproachRPR 29 2003 16:49 FR
SWOkane
TO 12087624507 P.05/05
Call 24 hours before inspection required
Phone 509.688-0036 Fax 509.688-0037
DEPARTMENT OF PUBLIC WORKS
Anticipated start date Permit # PWf PO 03-.27
APPROACH PERMIT
APPLICATION ,�"
Location of property 7)(3- 1► u).7_1 t
(Address/Parcel #, if available)
kY ll' th
Applicant Name V JCL
Phone aC r, —1t4 -q I (o
Contractor's Name V l Nita i tuciii {�c -
Address 1 o U, �I p �CQu Vt(� (a't�_2
Contractor's Re
Phone nrh-
Expires 3 (t t 1 ac\r-(
PROJECT DESCRIPTION Provide site sketch)
PgiResidential r riveway 0 Commercial/Industrial Driveway
n Existing Curb & Gutter ❑ Rural Road Section
nCulvert Installations n Sidewalk Repair/Construction
Other conditions .Y VLI Ti.i (`K)j2 kofls h? (i1 iii cI a
See construction requirements and details on reverse. Bondfinsurance certification must be on
Re with the City.
SPECIAL CONDITIONS:
PERMIT FEE $
Inspection Fee$
I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card.
Card # Expiration Date
Name of Holder
Signature .
Fees Paid$ 2c -cc") Date - T( Init,
.01
** TOTAL PRGE.05 **