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2003, 06-04 Permit App: BD-03-305 Approach
Si�k' Va11ey Call 24 hours before inspection required Phone 509.688-0036 Fax 509.688-0037 DEPARTMENT OF PUBLIC WORKS Anticipated start date L, -`s- Permit # PW ©3'3 o S APPROACH PERMIT APPLICATION Location of property &. \CN t (Address/Parcel #, if available) Applicant Name ->,„to, C o�'t• Address S • 3\� ‘-•• Phone �"\.'>-: c 5°r Contractor's Name Sc �a- Address Phone Contractor's Reg# Expires PROJECT DESCRIPTION (Provide site sketch) JResidential Driveway Commercial/Industrial Driveway Existing Curb & Gutter Rural Road Section Culvert Installation Sidewalk Repair/Construction Other conditions See construction requirements and details on reverse. Bond/insurance certification must be on file 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$ C2. Date !nit