2013, 03-15 Permit App: APR-2013-0005 Approach ;' ° Community Development Department (Staff Use Only)
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SCITY0k ',a�°. 11703 East Sprague Avenue, Suite B 3 PERMIT NUMBER:Ma.'/3—
pJI IIIe Spokane Valley, WA 99206
11 Val
��� Tel: (509) 688-0036 PERMIT FEE:
Fax: (509).688-0037
permitcenter@spokanevallev.orq
APPROACH PERMIT APPLI ATION
PROJECT ADDRESS: /3721_ c :,9J; ?7 � /i1- 1 ' 4-SZ)4 ,('3D,
START DATE: ..?--„,2_61-72 ANTICIPATED CO LETION DATE: E -„,z?/3
BUILDING OWNER NAME: /Y1gL_ /gLLEA 7)//Y6S
MAILING ADDRESS: /2&29 g W //►3 74?)A/ /` 2
CITY: Ml/ey /2 STATE: /a*/ ZIP: 9 'e 3
CONTACT PERSON NAME: ?, /LL ,ZD V/iC 7
PHONE: 509-- 953 -c_F�/5 FAX:5.0G-c=.27/ - ‘,2 CELL:---.56 J- g6---)3-_f-2e/5
CONTRACTOR NAME: VWL L/#fia r. Cci/r ' /- -
MAILING ADDRESS: /' 7gc72 1,41`cS67(1J/"'i 7
CITY: ( 1117/ey, ,4, STATE: lo( �'+ �fZZIIP:: 7< Q.3� 7 /
PHONE:SSU/ - 75��1J'f$ FAX: Iii.,-e9/-41'6‘.2.2 CELL: ,,5-�-J�TS (J [�
CONTRACTOR LICENSE No.:'//LLJC.O.55/jjC EXPIRES:f�.J 0?O/5 CITY BUSINESS LICENSE NO. f/0(310,,R45-
PROJECT
O(3Ig95.. y5-
PROJECT DESCRIPTION (Please Provide Site Sketch)
XResidential Driveway ReaoUe-t- ,fie PL.u4CE ❑ Commercial/Industrial Driveway
Existing Curb &Gutter LCX l STi'"j /VPROv/Crf❑ Rural Road Section
Culvert Installation ❑ Sidewalk Repair/Construction
❑ Other Conditions:
Bond/Insurance certification must be on file with the City.
DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) if this permit is for construction 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 permission to represent the property 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 Permit Center. 5) The City of
Spokane Valley permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be required to be sub ed and subsequently approved before this application cart be processed.
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Signature A / t ' J -it4'C e/ :'ale:
Project # �GOVeD
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R�11T GEN�E ,
\ C SN P BEN. # �'L--^''..._-•---'
Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Approach_Permit_1-11-11.doc
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