2005, 04-25 Permit App: 05001534 ROW, Plumbing Reversal, FixturesApr 11 05 12:06p NORMS EXCAVATING
*lane
4c Valley
5098920432
Call 24 hours before inspection required
Phgne3094588-0195 Fax 509.688-0037
DEPARTMENT OF PUBLIC WORKS
p.4
Anticipated start date. 4125105 Permit # Account # 000122
ROW CONSTRUCTION PERMIT
Location of property 13303 E. Cataldo
Applicant Name Troyer
(Address/Parcel 4, if available)
Address Same Fax 892-0482
Contractor's Name Norm's Excavating, Inc.
Address PO Box 574 Veradale, WA 99037 Phone 509/928-0580
Contractor's Reg# NORMSEI972BM Expires 01/14/07
PROJECT DESCRIPTION (Provide site sketch or plan as necessary for clarity)
El Driveway
❑ Gas Installation/Repair
x Sewer Connection
n Curb 8 Gutter
EH Cable/Conduit/Pole
n Other
Pavement Cut
ElSidewalk Repair/Construction
Dimensions
Bond/insurance certification must be on file with the City. Bond 4 103957298
Permittee Signature Approved
Date
I hereby authorize the City of Spokane Valley to charge the fee for this permit lo my credit card.
Card 4 Expiration Date 09/30/05
Name of Holder Sheila Gibbons Signature
Fees Paid$ 16.00
$25.00
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 525.00 (112 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
RPR 11 2005 12:17
0
5098920432 PRGE.04