2015, 03-10 Permit App: ROW-2015-0114 ROWII 03/10/2015 15:42 FAX 5094832525
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SPOKANE DITCH AND CABLE
->VVALLEY 12 001
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
perm Itcenteraspokanevallev.orq
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
RIGHT OF WAY (ROW) PERMIT APPLICATION
APPROACH
CURB & GUTTER
PAVEMENT CUT (SEE BELOW)i' SIDEWALK
WORK THROUGH MANHOLE 0 OTHER
ROAD OBSTRUCTION rfl NO YES (if yes, complete the following)
• % of street or # lanes that will be obstructed: A0470
• Length of time street will be obstructed:
=> If work closes more than 50% of a local access street, or closes any portion of an arterial street,
then a TRAFFIC PLAN IS REQUIRED ;i' Pre -Approved TCP Proposed:
PROJECT ADDRESS: 1 3302 al,L(,c.u_¢_ PARCEL NUMBER:
APPLICANT'S JOB #: /SO /3 8-/3 LOCATE TICKET #
START DATE: -3113)15 ANTICIPATED COMPLETION DATE:N3o/i5
PROJECT DESCRIPTION: vu /336
LU �L _`1-
e CAA,, R4-�- Q , 5 b c. 66-/c.
PROPERTY OR BUILDING OWNER INFORMATION (IF APPLICABLE)
NAME:
MAILING ADDRESS: CITY: STATE: ZIP:
PHONE:
FAX: CELL:
CONTRACTOR INFORMAATION
NAME: s�4 )p Vli`1.?F idf'C(2_f4r C l -Lk)Gr
MAILING ADDRESS: /P0 6 ,r� (p al 9 CITY:
PHONE: ) - S o 9 q V'3 12.7 2 -
FAX:
S �O I4 t Ai
0oe1—qs,
STATEZIP: 9 z, / 7
CELL:
CONTRACTOR LICENSE NO.: 51'O14,4bJ2c, `ie LC..
EXPIRES: 3/j 5`1 5 CITY BUSINESS LICENSE NO.:
BOND/INSURANCE CERTIFICATE # (per SVMC Title 10, Article 2):
CONTACT NAME: LC N
PHONE:
MAR 1 n.
Modified April 14, 2014 } :wL m 'V _' ._
htto•//www.sookanevalley.ora/fllestoraae/124/938/210%948J1496/2831/RCWPA oc
Received Time Mar, 10. 2015 1:26PM No.1578
Page 1 of 2
03/10/2015 15:42 FAX 5094832525 SPOKANE DITCH AND CABLE -> VALLEY
**** IF PAVEMENT CUT, COMPLETE THE FOLLOWING ****
X002
NATURE OF WORK:
(circle one)
Gas
Electric
Water
CATV
Communication
Sewer
Other
TYPE OF CUT/REPAIR:
Jcircle one)
Asphalt
Gravel
Concrete
Other
SIZE OF CUT
(width) x (length)
STAFF TO COMPLETE:
ROAD TIER: PAVEMENT CUT POLICY APPLIES?
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) Ownership of this Clty of Spokane Valley permit Inures 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 to be submitted and subsequently approved before this application can be processed.
EXPIRATION
Right-of-way permits Issued between AprII 1st and September 30th are valid for 30 days after the date of Issuance, with a one-time 30 -day
extension available. Right-of-way permits Issued between October 1°t and March 31st are valid until the following April 30th.
Applicant Signature:
Method of payment: ❑ Cash ❑ Check
Date: 3/ehs
isa** 0 Mastercard**
** If paying with credit card, the City will call for credit card Informatlon when the permit Is ready to be Issued.
PLEASE FAX TO CITY OF SPOKANE VALLEY (509) 688-0037 UPON COMPLETION
Modlfled AprII 14, 2014
http ://www.sooka neva Ilev.ora/fllestorage/124/938/210/948/149612831/ROWPA.doc
Received Time Mar. 10. 2015 1:26PM No. 1578
Page 2 of 2
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COMPANY NAME:
LOCATION OF CLOSURE_
DATE OF CLOSURE;
REASON FOR CLOSURE
TIME UNTIL COMPLETE RESTORATION:
PLACE ROAD WORK AHEAD SIGNS
ON ALL STREETS ENTERING
WORK ZONE WITH DISTANCES
PER CHART (TYP.)
Contractor must resolve aN local
access and safety issues.
All barricades, cones, and signs must
be in accordance with the latest edition
of the Manual on Uniform Traffic Control
Devices (MUTCD).
Flaggers must be State Certified, must
follow MUTCD-guidelines, and must use
and wear safety equipment as required.
Sidewalk closures require additional signage.
Temporary patching or use of Steel plates
must be preapproved and signed accordingly,
Drawing Not to Scale
0
Z Y
1 FLAGGER MAY BE USED IF SIGHT CONDITIONS PERMIT
x X
4k
0
0
0
ox
Z
0
0 0 0 0 0 0
NO PARKING SIGNS MUST BE INPLACE 24 HOURS IN ADVANCE' — --
UTILITY SERVICE INSTALLT
501/4 OF ROAD
2
00
0
0
0
0
SIGN SPACING REQUIREMENTS x)
RURAL ROADS & URBAN ARTERIALS 35!40 MPH 359' i_
RURAL ROADS, URBAN ARTERIALS,
RESIDENTIAL & BUSINESS DISTRICTS 25/30 MPH 200, 7 -
URBAN STREETS 25 MPH OR LESS 100'
MINIMU APER LENGTH L peg CHANNELI21NG
AND NUMBER OF DEVICES TO USE DEVICE SPACING feetSIM_
WidthMPH TAPER
Posted Speed Ike (mph)
25 30 35 40
1054 150/5 205/8 270/10
115T7 t65/9 22513 295/11
12517 150110 24519 320/12
10 feet SO 40
35/45 30
11 feet
12 reel
25730
TANGENT
B0
60
20 I 40
CONDITIONS MAY WARRANT ADJUSTMENT OF THESE DIMENSIONS
*°t
'—X
X X —
—X—
' 2015
77
OPTION FOR LOW VOLUME ROADS INSTEAD OF FLAGGERS
THIS SIGN TO BE FOR BURDENED TRAFFIC ONLY
CITY OF SPOKANE
ENGINEERING SERVICES
TRAFFIC CONTROL PLAN
50% CLOSURE ON LOW VOLUME ROAD