2006, 04-28 Permit App: 06001642 ApproachC•ornrntlniti- Dev �lop.,:ent
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Approach Permit Application
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STi -P:I' DEQ i L ,'t1,4TICP ATI D COR�PI .I TION DA"PL
Contractor:
Name:
Address:
City: State: Zip:
Phone: Fw,:
Contractor Lic No: V I K 1 gC tq ,, Exp Date:
City Business Lic. No:
PROJECT DESCRIPTION (Provide site sketch)
�I?`- Res.ident:ial Driveway [_l Coimlercial/Industrial Driveway
Existing Curb & Gutter I I Rural Road Section
Cu]eert.. Installation Ll Side-wafk Repair/Construction
F] Other Conditions
Bond/Insurance certification must be on file with the city.
DISCLAIMER
The permittee verifies, aclunowledges and agrees by their signatures that: 1) If this permit is for construction of or on a dwelling, the
dwelling, is/will be served by potable water. 2) Ownership of this City of Spokane Valley Permit inure to the property owner. 3) The
signatory is the property owner or has perrriission t:o represent the properly owner in this transaction. 4) All construction is to be done in
full compliance with the City of Spokane Valley Development. Code. Referenced codes are available for review at the City of Spokane
Valley Pernut Center. 5) This City of Spokane Valley Permit is not a penrtit or approval for any violation of federal, state or local laws,
codes or ordinances. 6) Plans or additional information may be required to be submitted, and subsequently approved before this
application can be processed.
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Signature
hsetbod of Payment:
❑ Cash ❑ 'Check I � 1v7astercard
Barkcard =.
*.Lh,xized Signature:
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