2005, 07-08 Permit App: 05002314 ROWFROM : NORM'S EXCAVATING
/IN/alley
FAX NO. : 509 892 0432 Jun. 30 2005 08:37AM P4
Call 24 hours before inspection required
Phone 509.688-0195 Fax 509.688-0037
DEPARTMENT OF PUBLIC WORKS
Anticipated start date 7/13/05 Permit # Account # 000122
ROW CONSTRUCTION PERMIT
Location of property 508 N. Bates
Applicant Name Hetzel
(Address/Parcel #, if available)
Address Same Fax 892-0482
Contractor's Name Norm's Excavating, Inc.
Address PO Box 574 Veradale, WA 99037 Phone 5091928-0580
Contractor's Reg NORMSEI972BM Expires 01/14/07
PROJECT DESCRIPTION (Provide site sketch or plan as necessary for clarity)
x I Sewer Connection ❑ Driveway
❑ Curb & Gutter ❑ Gas Installation/Repair
El Cable/Conduit/Pole ❑ Sidewalk Repair/Construction
pi Other
I] Pavement Cut
Dimensions
Bond/insurance certification must be on file with the City. Bond # 1039. 7298
Permittee Signature Approved
Date
I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card.
Card* Expiration Date 09130/05
Name of Holder Sheila Gibbons Signature
Fees Paid$ 16.00 $25.00
(Application) (Inspection)
Date
/nit
In addition to the permit application fee of $16.00 (utility) or $25.00 (construction). inspersion 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.
Work completed satisfactorily (Signed)
Date
Permit not valid until One -Call Notification Ticket # entered here
PERMIT MUST BE KEPT ON SITE