2005, 08-22 Permit App: 05003069 ROW ' BC:ST SBBC CC ui ro
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Cali 24 hours before inspection required Yt'-Phone 509.688-0195 Fax 509.688-0037
Smrokne
lley DEPARTMENT OF PUBLIC WORKS
Anticipated start date Aug 24, 2005 Permit* Account* 000122
ROW CONSTRUCTION PERMIT
Location of property 6418 E.8th
(Address/Parcel#, if available)
Applicant Name Whitehouse
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# NORMSE1972BM Expires 01/14107
PROJECT DESCRIPTION(Provide site sketch or plan as necessary for clarity)
x Sewer Connection El Driveway
I I Curb 8 Gutter n Gas Installation/Repair
ri Cable/Conduit/Pole n Sidewalk Repair/Construction
n Other
Pavement Cut Dimensions
Bondtinsurance certification must be on file with the City.Pond# 103957298
SPECIAL CONDITIONS:
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 Paids 70.00 Date Init
(Application) (Inspection)
In addition to the penal application fie 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 terms and provisions.
Work completed satisfactorily(Signed) Date
Permit not valid until One-Call Notification Ticket#entered here
PERMIT MUST BE KEPT ON SITE
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