2005, 09-23 Permit App: 05003496 ROWSPECIAL CONDITIONS:
ca1124 boors below iospcction.xcquicd
I'moc 509.688-0036 Fax 509688-0037
DEPARTMENT OF PUBLIC WORKS
Anticipated start date
Permit # PW
ROW CONSTRUCTION PERMIT
Location of property 90Z C, cd
Applicant Name r Y (..
Address 9h� c� i Y i A ck C ckv Phone Sci — 3 4LT
Contractor's Name 4" �ld/U S't Y' (.�-C�'L Cil /j
Add1 s /1 CI ! it Val fr ( Plainegad —4'!' %*
Contractors Ra JJJ /
PROJECT DESCRIPTION( (Provide alta sketch or plan as necessary for clarity)
(Address/Parcel #, ff available)
27}Sewer Connection
ri�& Gutter
El Cabin
Other
EDriveway
El Gas
Installation
nSidewalk Repair/Construction
Pavement Cut? Dimensions
Bondlinsurance codification must be on file watt the ' . Bond #
.34q
Permittee Signature Approved
1 hereby authorize be Cit/ arSpokane Yancey b dhergo the foe foriNs permit b nw ala alt cad.
cad # ExpiraticeDale
Name of Folder
Fees Paid$
(Application) (Inspection)
In addition to the permit application fee of $18.00 or $2540, inspection on each permit will be
billed to the permlttee at a rate of $60.00 per hour with a $28.00 (1/2 hour) minimum. Permittee
signature on permit constitutes an agreement to these terms and provisions.
Work completed satisfactorily (Signed) Date
Date
Inst
t/-vr ... s !1 ... .00.11AUdituatitivs Tiel1mt if entered bare