2005, 08-15 Permit App: 05002937 Row ObstructionAug 15 05 09:59a NORMS EXCAVATING p.6
SPoliane
,o0Valley
Call 24 hours before inspection required
Phone 509.688-0195 Fax 509.688-0037
DEPARTMENT OF PUBLIC WORKS
CDs-- 2_97D R
I I I UD
Anticipated start date 8/22/05 Permit # Account # 000122
ROW CONSTRUCTION PERMIT
Location of property 1315 N. Boeinz
Applicant Name Eschette
Address Same Fax 892-0482
(Address/Parcel #, if available)
Contractor's Name Norm's Excavating. Inc.
Address PO Box 574 Veradale, WA 99037 Phone 509/928-0580
Contractor's Reg # NORMSEI972BM Expires 01114107
PROJECT DESCRIPTION (Provide site sketch or plan as necessary for clarity)
Fcl Sewer Connection LJ Driveway
F1 Curb & Gutter 111 Gas Installation/Repair
Cable/Conduit/Pole Ei Sidewalk Repair/Construction
Other
—1 Pavement Cut
Dimensions
Bond/insurance certification must be on file with the City. Bond # 103957298
SPECIAL CONDITIONS:
Permittee Signature Approved Date
1 hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card_
Card # Expiration Date 09/30/05
Name of Holder Sheila Gibbons Signature
Fees Paid$ 70.00
Date
lnit
(Application) (Inspection)
in addition to the permit application fee of $16.00 (utility) or $25.00 (construc:hon), inspection on
each permit will be billed to the permittee at a rate of $50.00 per hour with a $25.00 (112 hour)
minimum. Permittee signature constitutes an agreement to these terms and provisions.
Work completed satisfactorily (Signed)
Permit not valid until One -Call Notification Ticket # entered here
AUG 15 2005 10:14
Date
PERMIT MUST BE KEPT ON SITE
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