2011, 08-09 Permit App: 11002380 ROW*lane�
,Malley
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Call 24 hours before inspection required
Phone 509.688-0195 Fax 509.688-0037
DEPARTMENT OF PUBLIC WORKS
Anticipated start date Aug 16 , 2011 Permit #
000122
ROW CONSTRUCTION PERMIT
Location of property 14117 E Boone
(Address/Parcel #, if available)
Applicant Name Dietzel
Account #
Address Same Fax 892-0432
Contractor's Name _ Norm's Excavating, Inc.
Address PO Box 574 Veradale, WA 99037 Phone 5091928-0580
Contractor's Reg NORMSEI972BM Expires 01/14/13
PROJECT DESCRIPTION (Provide site sketch or plan as necessary for clarity)
Sewer Connection Driveway
Curb & Gutter Gas Installation/Repair
ElSidewalk Repair/Construction
x
Cable/Conduit/Pole
n Other
nPavement Cut
Dimensions
Bondlnsurance certification must be on file with the City. Bond # 103957298
SPECIAL CONDITIONS:
Permittee Signature Approved
Date
I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card.
Card # see cover sheet Expiration Date
Name of Holder Sheila Gibbons Signature
Fees Paid$ 110.00
(Application)
(Inspection)
Date
Init
In addition to the permit application fee of $16.00 (utility) or $25.00 (construction), inspection on
each permit will be billed to the permittee at a rate of $50.00 per hour with a $25.00 (1/2 hour)
minimum. Permittee signature constitutes an agreement to these terms and provisions.
Permit not valid until One -Call Notification Ticket # entered here
PERMIT MUST BE KEPT ON SITE
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