2004, 11-23 ROW Construction Permit•••4"so..,
SINIkane
40Valley
Call 24 hours before inspection required
Phone 509n8-0195 Fax 509.688-0037
DEPARTMENT OF PUBLIC WORKS Nov. 23, 2004
Anticipated start date 12/02/04 Permit #
ROW CONSTRUCTION PERMIT
Location of property 1722 N. Herald Rd
(Address/Parcel #, if available)
Applicant Name Tuttle
Account # 000122
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 01/14/05
PROJECT DESCRIPTION (Provide site sketch or plan as necessary for clarity)
I X I Sewer Connection Driveway
❑ Curb & Gutter Gas Installation/Repair
❑ Cable/Conduit/Pole
Other
Pavement Cut
nSidewalk Repair/Construction
Dimensions
Bond/insurance certification must be on file with the City. Bond # 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 _ $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 (1/2 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