2011, 07-06 Permit App: 11001868 GradingProject Number: 11001868 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 7/6/2011 Page 1 of 2
Proiect Information:
Permit Use: FILL IN BACK NORTH PART OF LOT TO EVEN
UP ELEVATION -495 CU YD
Setbacks: Front
Site Information:
Plat Key:
Left Right: Rear:
Name: Range
Parcel Number: 55173.0702 Block:
SiteAddress: 18911 E ALKI AVE
Location:: CSV
Contact: KIENBAUM, WAYNE & TINA, DALLES
Address: 4502 S CONKLIN RD
C - S - Z: SPOKANE VALLEY, WA 99016
Phone: (509) 922 -5829
Group Name:
Project Name:
Lot:
Owner: Name:
Address:
Zoning: RC Regional Commercial
Water District: 134 CONSOLIDATED ID #19
Area: 48,500 Sq Ft Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Review
Dev Eng Review
Permits:
Contractor: OWNER
District: East
KIENBAUM, WAYNE & TINA, DA
4502 S CONKLIN RD
SPOKANE VALLEY, WA 99016
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Released By:
Originally Released: 7/6/2011 By: WMCGAV
Grading Permit
Firm: OWNER
Phone: (000) 000 -0000
This Application:
Description Grp Type Notes Su Ft Valuation
GRADING NONE NONE 495 $495.00
Item Description
GRADING PLANS CHECK
GRADING PERMIT FEE
Totals: 495 $495.00
Units Unit Desc
1 SELECT
1 SELECT
Operator: jmm Printed By: jmm
Permit Total Fees:
Print Date:
Total Project:
Su Ft Valuation
495 $495.00
495 $495.00
Fee Amount
$20.00
$48.00
$68.00
7/6/2011
Project Number: 11001868 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 7/6/2011 Page 2 of 2
Notes:
Parcel to be graded so that storm water does not flow onto neighboring properties.
Payment Summary:
Permit Type
Grading Permit
Fee Amount
$68.00
$68.00
Invoice Amount
$68.00
$68.00
Amount Paid
$0.00
$0.00
Amount Owing
$68.00
$68.00
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and /or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of
the provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: jmm Printed By: jmm
Print Date: 7/6/2011
Stioliane
Mtlley
pC:rCIV
cornmu ity DevelopMerit Departrnen
Permit Center
11703 East Sprague Avenue3Llite
Spokane Valley, WA 992
Tel: (509) 720-5240
Fax: (509) 688-0037
LAND DISTURBAWC44 PERMIT APPLICATION
p_eonitctat
(Staff Use Only)
PERMrf NO.:
CHEattall: OT ON INITI
STAFF USE :
ENGINEERED GRADING
REGULAR GRADING GRUBBING & CLEARING
APPLICANT USE:
SITE ADDRESS:
ASSESSORS PARCEL NO.: SS- k
APPLICANT NAME: Lk )C4 e 1,1 eAAA 4, 4-1
PHONE: ST` )el EMAIL: \.i + e t)cl
CONTACT NAME (0 SAME AS APPLICANT):
PHONE:
LOT 2 BLOCK 1 OF GARVVOOD SUB-DIV OF CORBIN ADDITION
TO GREENACRES, IN THE COUNTY OF SPOKANE AND THE STATE OF
WASH. AS PER MAP THEREOF RECORDED IN BOOK "X" OF PLATS.PAGE 18
cT4 .
CEU.: ItPq ')2C 6H
EMAIL:
CELL:
PROPERTY OWNER NAME:
5kCHECK IF APPLICANT
MAILING ADDRESS: 56'
PHONE:
STATE: \VA
EMAIL:
CELL:
ZIP: C/90 t
CONTRACTOR NAME: (0 TBD):
MAILING ADDRESS:
CITY: STATE:
PHONE: EMAIL: CELL:
STATE LIC. NO.: LXPIRE,;: UB1:
CHECK IF APPLICANT
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
(3(L e,
A 6A4 k No, irs)
Sec At It* 1),“,.4)%
ESTIMATED QUANTITIES (CUBIC YD): CUT: FILL:
IF CUT, PROVIDE DESTINATION OF SOIL:
START DATE: Jc ti ESTIMATED COMPLETION DATE:
Updated March 2011
WSV-FS21Public Folders\ ommunity Developmentk02 Administration\03 Forms - Official Versions\Permit Center\Land Disturbance Permit & ChecKst 3-
29-11 doc
/33/20t
SItpokane
Va11ey
LAND DISTURBANCE (LD) PERMIT CHECKLIST
Permit Center ♦ 11703 E Sprague Ave Suite B -3 • Spokane Valley WA 99206
509.688.0197 i Fax: 509.688.0037 ♦ permitcenter @spokanevattey.org
Project Address:
Project Description:
Signature
i_ c L
Today's Date:
Print Name: C ..-)Q‘,?
The purpose of thin checklist is to gather information about the proposed project so to determine what land
disturbance permit, if any, is required by the Spokane Valley Municipal Code (SVMC).
Starting with Part 1 and working from top to bottom, please answer the following questions.
The first "Yes" identifies the type of land disturbance (LD) permit required.
PART 1 - Is LD work exempted or already covered? (SVMC 24.50.020) If so then LD permit not needed.
❑ Yes ' j No Does your project only have to do with emergency utility work: cemetery graves: eliminating
septic tanks; digging out a basement; building a wail less than 4 feet high; disposal of refuse
that is covered under other regulations; already permitted mining, quarrying, stockpiling of
aggregate material (rock, sand, gravel, aggregate, or clay) or exploratory excavations done
under the direction of a licensed engineer or engineering geologists? If yes, then project
exempted from a LD permit.
PART 2 - Engineered Grading Permit needed? (SVMC 24.50.030)
❑ Yes No Will this grading be for a short plat, subdivision or binding site plan?
❑ Yes No Will any grading occur in a FEMA floodplain, wetland, wetland buffer, Fish and Wildlife
habitat conservation area or geologically hazardous area?
11 Yes tig No Will the volume of excavation or fill for the project be over 500 cubic yards?
❑ Yes . No Will the grading create a base or support for a permanent structure?
❑ Yes No Will the grading be for a driveway that is longer than 75 feet?
El Yes ❑ No Will any grading occur in a drainage channel or be for a water feature (like a pond) with a
surface area greater than 500 square feet?
❑ Yes No Will any excavations or fills have slopes at 2:1 (H:V) or steeper and heights greater than 216
feet?
❑ Yes ❑ No Will any excavations or fills have slopes at 10:1 (H:V) or steeper and heights greater than 4
feet?
PART 3 - Regular Grading Permit needed? (SVMC 24.50.040)
j Yes ❑ No Will the volume of excavation or fill be over 50 cubic yards on any one lot?
❑ Yes No Will any excavations have slopes at 2:1 (H :V) or steeper or heights greater than 3 feet?
D Yes Fj No Will any fills have slopes at 2:1 (H:V) or steeper or heights greater than 2 feet?
PART 4 - Grubbing and Clearing (G&C) Permit needed? (SVMC 24.50.050)
❑ Yes No Will the G &C work disturb 5,000 or more square feet of area or remove 7 or more trees?
(Note that forest practices overseen by DNR or commercial agriculture are exempt)
❑ Yes No Will there be any clearing on slopes or near /in FEMA floodplains, wetlands, wetland buffers,
Fish and Wildlife habitat conservation areas, geologically hazardous areas or erodible soils?
If the answers to all of the questions above are "No" then a permit is not required for the proposed work
Updated March 2011
11SV- F521Pubiic Folders\Communtty Development\02 Administration103 Forms - Official Versions\Permit Center1Land Disturbance Permit & Checklist 3-
29-11.doc
■■
•
■ - •
■
JUN -20 -2011 17:30
•Valley.
Imunity Development Department
•ertnit Center
11703 East Sprague Avenue, Suite 8 -3
Spokane Valley, WA 99206
Tel: (509) 720 -5240
Fax: (509) 688 -0037
permitcenter(-1a 5pokanevallev.org
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
GRADING PERMIT APPLICATION
SVMC 24.50 LAND DISTURBING ACTIVITIES
ROUGH /CLEARING FULL GRADING
SITE ADDRESS: 1 ?g9 J l
P.01/02
UNDERGROUND El , SITE
ASSESSORS PARCEL NO.:55173.0702 LEGAL DESCRIPTION:LOT 2 BLOCK 1 OF GARWOOD
SUB -DIV. OF CORBIN ADDITION TO GREENACRES, IN THE COUNTY OF SPOKANE AND THE STATE OF WASH. AS PER MAP
THEREOF RECORDED IN BOOK "X° OF PLATS,PAGE 18.
PROPERTY OWNER NAME:WAYNE KIENBAUM
MAILING ADDRE$s:4502 S. CONKLIN
MANAGER :SELF
CrrY:GREENACRES STATE:WA Zip:99016
PHONE:509- 924 -6709 FAx:509 -924 -9045 CELL :509- 220 -6483
CONTACT NAME:WAYNE KIENBAUM
PHONE:509- 924 -6709 FAx:509 -924 -9045 cm :509-220-6483
EXCAVATION CONTRACTOR NAME:NONE / SELF REFORM
MAILING ADDRESS:
CITY:
STATE:
ZIP:
PHONE:
FAX: CELL:
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
COMPANY NAME:NoNE
MAILING ADDRESS:
Cm:
STATE: ZIP:
PHONE:
FAX: CELL:
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
SOIL TESTING FIRM NAME:NONE
MAILING ADDRESS:
Cm:
STATE:
ZIP:
PHONE:
FAX: CELL:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
LEVELING OF UN -EVEN GROUND
ESTIMATED EXCAVATION /CUT (CUBIC YD):NONE
R e c e'Hied ' *PT hm e 1 Jun. 2. w 2 011,k 5: 2 2 PMaN o. 3 O 3 5age/124/938/210/ 948 /1496 /Grading_Permlt- 1- 11-11.doc Page 1 of 2
JUN -20 -2011 17:30 P.02/02
ESTIMATED EMBANKMENT /f (CUBIC YD):NO EMBANKMENT. JUST FP ' 900
DESTINATION OF EXCAVATED MATERIALS:N /A
START DATE:JULY 2011 ESTIMATED COMPLETION DATE:JuLY 2011
DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) If this permit Is for construction or on a dwelling, the dwelling Is /will
be served by potable. water. 2) Ownershlp of thls City of Spokane Valley permit Inure to the property owner. 3) The signatory Is the property
owner or has permission to represent the property owner in this transaction. 4) All construction is to be done In full compliance with the City of
Spokane Valley Development code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) The Clty of
Spokane Valley permit Is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
Information may be required b d subsequently approved before thls applicatton can be processed-
Signatur
Date:6 -20 -11
R e c e liiv e d f T Im e l Jun, 20. w 2 011 ,k 5: 2 2 P M.oN o. 3 0 3 Sage/ 124/ 938 /210/ 948 / 1496 /Grading_Permit_1- 11 -11.dc Page 2 of 2
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Site Address: 18911 E ALKI AVE
Parcel Number: 55173.0702
Zoning: RC
Fire District: FD 01
Project
Transmittal
City of Spokane Valley
Community Development
Department
11703 E. Sprague Ave, Suite B3
Spokane Valley, WA 99206
Phone: 509.688.0036
New project fl
Previous pre -app meeting
Plan revisions ❑
Transmittal Date:
Friday, June 24, 2011
Project Number: 11001868
Water District: CONSOLIDATED ID #19
Applicant: KIENBAUM, WAYNE & TINA, DALLE
4502 S CONKLIN RD
SPOKANE VALLEY, WA 99016
(509) 922 -5829
e -mail: e-mail:
Occupant:
Owner: KIENBAUM, WAYNE & TINA, DALL
4502 S CONKLIN RD
SPOKANE VALLEY, WA 99016
Contact: KIENBAUM, WAYNE & TINA, DALLE
4502 S CONKLIN RD
SPOKANE VALLEY, WA 99016
(509) 922 -5829
e -mail:
Contractor: OWNER
( ) - 0
e -mail:
Arch / Engineer:
e -mail:
Project FILL IN BACK NORTH PART OF LOT TO EVEN UP ELEVATION -495 CU YD
Description:
Building
Landuse
Engineer
Utilities
Health
Fire Dist
Assessor
APPLICATIO
h
GRADING PLAN
S
Please send all plan review and project comments via e-mail to the
highlighted individuals.