2005, 05-10 Permit App: 05001546 ROW, Plumbing Reversal£0'30Ud i;£40i'68605
SO:lane
vaiey
L£:L0 SOOE 0T AUW
Call 24 hours before inspection required
Phone 509.688-0195 Fax 509.688-0037
DEPARTMENT OF PUBLIC WORKS 09
Anticipated start date May 26, 2005 Perrnit #
ROW CONSTRUCTION PERMIT
Location of property 13222 E. Desmet
Applicant Name Fleck
Address
(Address/Parcel #, if available)
Account ft 000122
Same Fax 692-0482
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)
nSewer Connection Driveway
n Curb & Gutter fl Gas Installation/Repair
ri Cable/Conduit/Pole n Sidewalk Repair/Construction
ri Other
nPavement Cut
Dimensions
Bond/insurance certification must be on file with the City. Bond # 103957298
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 09130/05
Name of Holder Sheila Gibbons Signature
Fees Paid$ 16.00 $25.00
Date
Unit
(Application) (Inspection)
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.
Work completed satisfactorily (Signed)
Permit not valid until One -Call Notification Ticket it entered here
E'd ZEU0368609
Date
PERMIT MUST BE KEPT ON SITE
ONIIVAVDX3 SAHON eLZLO 90 OL ABA