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2005, 09-27 Permit App: 05003514 ROW, Plumbing FixturesSep 26 05 09:25a NORMS EAU/WA I IrJU 1 Spokane ,'Valley - Call 24 hbvfs before inspection required Phone 509.688-0195 Fax 509.Q8-0037 DEPARTMENT OF PUBLIC WORKS Anticipated start date 1013/05 Permit# ROW CONSTRUCTION PERMIT Location of property 812 N. Ravalli Dr. (Address/Parcel #, if available) Applicant Name Coutts Address Same Fax 892-0482 Account # 000122 Contractor's Name Norm's Excavating, Inc. Address PO Box 574 Veradale, WA 99037 Phone 509/928-0580 Contractor's Reg# NORMSEI972BM Expires 01/14107 PROJECT DESCRIPTION (Provide site sketch or plan as necessary for clarity) nDriveway nGas Installation/Repair USidewalk Repair/Construction 7 Sewer Connection Curb & Gutter Cable/Conduit/Pole n Other Pavement Cut Dimensions Bond/insurance certification must be on file with the City. Bond # 103957298 Permittee Signature Approved Date 1 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$ 70.00 (Application) (Inspection) Date [nit In addition to the permit application fee of $16.00 (utility) or $25.00 (construction). inspection an 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 SEP 26 2005 09:41 PAGE.09