2005, 07-22 Permit App: 05002515 ROW, Plumbing ReversalFROM : NORM'S EXCAUATING
FAX NO. : 509 892 0432 Jul. 22 2005 10:35PM P2
Call 24 hours before inspection required
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Phone 509.688-0195 Fax 509.688-0037
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pokane
1151 -
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DEPARTMENT OF PUBLIC WORKS
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Anticipated start date Aug 3, 2005 Permit # Account # 000122
ROW CONSTRUCTION PERMIT
Location of property 14604 E. Nixon
Applicant Name Hasting
(Address/Parcel #, if available)
Address Same Fax 892-0432
Contractor's Name Norm's Excavating, Inc.
Address PO Box 574 Veradale, WA 99037 Phone 509/928-0580
Contractor's Reg# NORMSE1972BM Expires 01/14/07
PROJECT DESCRIPTION (Provide site sketch or plan as necessary for clarity)
l x l Sewer Connection ( Driveway
C
Curb & Gutter
Cable/Conduit/Pole
Other
Pavement Cut
nGas Installation/Repair
Sidewalk Repair/Construction
Dimensions
Bond/insurance certification must be on file with the Cit Bond # 103957298
SPECIAL CONDITIONS:
Permittee Signature Approved
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 Gi ons Signature
Fees Paid$ 70.00
(Application)
(Inspection)
Date
Date
blit
In addition to the permit application fee of 816.00 (utility) or $25.00 (construction), inspecton 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 ft entered here
PERMIT MUST BE KEPT ON SITE
JUL 22 2005 10:46
509 892 0432 PAGE.02