2005, 06-13 Permit App: 05002045 ROW, Plumbing Reversal11'30ed 2£40E6E1609
*lanee
sonalley
£Z:PT seen £T Nnf
Call 24 hours before inspection required
Phone 509.688-0195 Fax 509.688-0037
DEPARTMENT OF PUBLIC WORKS
Anticipated start date June 20,2005 Permit # Account # 000122
ROW CONSTRUCTION PERMIT
Location of property 13304 E. Catalde
(Address/Parcel #, if available)
Applicant Name Tollett
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# N0RMSEI972BM Expires 01114/07
PROJECT DESCRIPTION (Provide site sketch or plan as necessary for clarity)
Sewer Connection Driveway
x
Curb & Gutter ❑ Gas Installation/Repair
n Cable/Conduit/Pole n Sidewalk Repair/Construction
I ! Other
Pavement Cut
Dimensions
Bond/insurance certification must be on file with the City. Bond # 103957295
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
$25.00
Date
!nit
(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 (12 hour)
minimum. Permittee signature constitutes an agreement to these terns and provisions.
Work completed satisfactorily (Signed)
Permit not valid until One -Call Notification Ticket # entered here
LI'd Z£70Z69609
Date
PERMIT MUST BE KEPT ON SITE
ONI!VAVOX3 SINHON
d(i: o SO £( unr