2005, 07-08 Permit App: 05002313 ROWFROM : NORM'S EXCAVATING
Spokane
Valley
FAX NO. : 5 ft '1392 0432 Jun. 30 2005 08:37AM P3
la
Call 24 hours before inspection required
Phone 509.688-0195 Fax 509.688-0037
DEPARTMENT OF PUBLIC WORKS
os�-3313
Anticipated start date 7/14105 Permit # Account # 000122
ROW CONSTRUCTION PERMIT
Location of property 12802 E. Cataldo
(Address/Parcel #, if available)
Applicant Name Moore
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 n Driveway
I-1 Curb & Gutter Gas Installation/Repair
Cable/Conduit/Pole ❑ Sidewalk Repair/Construction
El Other
ri Pavement 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.
Cerd # Expiration Date 09/30/05
Name of Holder Sheilabbons Signature
Fees Paid$ 16.00 $25.00
(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.
Date
Init
Work completed satisfactorily (Signed)
Date
Permit not valid until One -Call Notification Ticket # entered here
PERMIT MUST BE KEPT ON SITE