2005, 09-13 Permit App: 05003364 Sewer ReversalSep 09 05 04:15p NORMS EXCAVATING
o
(490 Co
Call 24 hours before inspection required
Phone 509.688-0195 Fax 509.688-0037
DEPARTMENT OF PUBLIC WORKS
Anticipated start date 9/19105 Permit #
ROW CONSTRUCTION PERMIT
Location of property 11702 E. Valley Way
(Address/Parcel #, if available)
Applicant Name Schneider
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 01/14107
PROJECT DESCRIPTION (Provide site sketch or plan as necessary for clarity)
171 Sewer Connection 0 Driveway
Curb & Gutter n Gas installation/Repair
Cable/Conduit/Pole n Sidewark Repair/Construction
1-1 Other
nPavement Cut
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 lo charge the fee for this permit to my credit card.
Card # Expiration Dale 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 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
SEP 09 2005 16:30
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