2003, 06-19 Permit: PW03-376 Approach Call 24 hours before inspection required
car Phone 509.688-0036 Fax 509.688-0037
Spokane
...A-Valley
DEPARTMENT OF PUBLIC WORKS
Anticipated start date Permit # PW uc---4,7 Ce
APPROACH PERMIT
APPLICATION
Location of property 30 S . of e l l L k
(Addy ss/Parcel #, if ailable)
Applicant Name CA k c--- Sc kyi, t.1 -�
Address 1 (a c c� � Phone
a) 1 S PGrd � 77 3Let 3
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K
Contractor's Name
Address Phone
Contractor's Reg# C 1 l'CkC 1O4 p Expires i1)7-7
PROJECT DESCRIPTION (Provide site sketch)
Residential Driveway I I 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$___ 06 Date Init