2005, 06-17 Permit App: 05002046, ROW, Plumbing Reversal90'39ed Z£70Z6B60s
Spokane
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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 June 21,2005 Permit # Account # 000122
ROW CONSTRUCTION PERMIT
Location of property 13001 E. Cataldo
(Address/Parcel #, if available)
Applicant Name Butcher
Address Same
Contractor's Name Norm's Excavating, Inc.
Fax 892-0482
Address PO Box 574 Veradale, WA 99037 Phone 5091928-0580
Contractor's Reg# NORMSEI972BM Expires 01/14/07
PROJECT DESCRIPTION
x
Sewer Connection
n Curb & Gutter
Cable/Conduit/Pole
n Other
InPavement Cut
(Provide site sketch or plan as necessary for clarity)
nDriveway
LIGas Installation/Repair
Sidewalk Repair/Construction
Dimensions
Bondfinsurance certification must be on file with the City. Band # 103957298
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 09/30/05
Name of Holder Sheila Gibbons Signature
Fees Paid$ 16.00
$23.00
Date Init
(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 4 entered here
Date
PERMIT MUST BE KEPT ON SITE
8'd Z£bOZ68609 ONIlVAVOX3 SINHON
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