2005, 08-05 Permit App 05002766 ROW for Sewer� 70, 00
Anticipated start date
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Phomc 5W 6W -0M Fax 509.688-0037
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DEPARTMENT OF PUBLIC WORKS
Permit # PW
ROW CONSTRUCTION PERMIT
Location of property. � 4] {—_ 6-c �, C'
A' (Address/Parcel #, If available)
Applicai
Address
hone
Contractor's Name Y '�- ,3 t..tQ/U. al- Y t'c:i' _.a n
PRQJEO' DF.SG$IPTIDN (Provide alto skatch or plan as nscewmry for clarity)
Sewer Connection ❑ Driveway
Caarb & Guftw &ts !kx;LW& r W
0UW
Pareenrw1vtlt Cut? Dutra
BondAr-pin stos cmIfficadon must be on iib w lh Me M. Bold
« «�Z111 10
r.
Parmittee Signature Approved
I hmeby acct =Lw ti're MY of Si`AA=W Yaley b dxgp to tee for Mb Wnali b My CrSA cast.
Card # Dd
Mame of Hoickw
Fens Paid$ Date Init
(Application) (Inspection)
In addition to the permit application fee of $96.00 or $25,00, Inspocuon on each pamA wUl be
billed to the permittoo at a rate of X60.00 per hour with a $26.00 (9/2 hour) mintmum. Permlaft
sJgnature on permit conglitrtes an agreement to these terms And provislona.
Work completed satisfactorily (Signed) Date
-• •• • •-` __a„ rte.., J .-11 nr-"01-s in.. TiolrAt fi mntared here