2015, 03-12 Permit App: ROW-2015-0118 ROWPermit CenteDevelopment Department
Permit Center
�,�. 11703 East Sprague Avenue, Suite B-3
®'CaneSpokane Valley, WA 99206
- Tel: (509) 688-0036
������- Fax: (509) 688=0037 -
Fax:per(center88-00 anevallev.orq
(Staff Use Only)
PERMIT NUMBER:
RIGHT OF WAY (ROW) PERMIT 4PPLICATION
D APPROACH Q PAVEMENT CUT (SEE BELOW) ® SIDEWALK
® CURB & GUTTER . ®. WORK THROUGH MANHOLE OTHER
ROAD OBSTRUCT'II-ON ticNO ® YES (if yes, complete the following)
k6?41 • % of street or # lanes that will be obstructed:
• 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 Ig Pre -Approved TCP Proposed:
PROJECT ADDRESS: 19921 .6: Ce(; kg 4»e• PARCEL NUMBER:
APPLICANT'S 30B #: R1196 LOCATE TICKET# /SO 6199,Y START DATE: 3-J3. 2)/5 ANTICIPATED COMPLETION DATE 9-3•..0/5
PROJECT DESCRIPTION: ''J
nIr.'Di�hein.LU/9 7�
/Wove ozD't. r/I/eq q
PX 0.514.49 6041 Pede5tt,/ Out- of F.41 -e Rocckwc.1,
PROPERTY OR BUILDING OWNER INFORMATION (IF APPLICABLE)
NAME:
"MAILING ADDRESS:
CITY:.
STATE: ZIP:
PHONE:
FAX:
CELL:
CONTRACTOR IN/FORMATION 8;11 +0
NAME: SC�)nL±Lo On1M4A Ica Lon
MAILING ADDREESS: 3(:%1.' r /. nor et RA
PHONE: 5o9-53a-U.3oV
4ir cast (a11k
cnv: 5poitgne Vc,lle y
FAX:: 301 -53..? -..55%/5 CELL::
STATE:
WA.
ZIP: 99216
CONTRACTOR LICENSE NO.: 6Q19 . 1 191 _. EXPIRES: .. CITY BUSINESS LICENSE NO.:
BOND/INSURANCE CERTIFICATE # (per SVMC Title 10, Article'2):
CONTACT NAME: 1 &cI fire/loci n
PHONE:
SEFNcs ollyPy
0; -6,83- 7959
RECEIVED
CSV PERMIT CENTER
MR 12 2015
Project # Z
I,�WO-7ri/S -a19
Name 7!i •
'Submittal;-- ..
Modified April 14, 2014 -
httpilkyww cookanevallevgrgLautoraoe/124/938/210/948/1496/2831/ROWPA CIC
Page 1 of 2
****-+IF.PAVEMENT CUT, COMPLETE THE FOLLOWING ****
NATURE OF WORK:Gas
Electric
Water
CATV
Communication
Sewer
Other.
TYPE OF CUT/REPAIR
-_ .._.
(circle one)'
_ Asphalt—
_ .:
Gravel_
,..,�Concrete
Other
SIZEOFCUT
(width) x (length)
- --�
STAFF TO COMPLETE:
ROAD TIER:
PAVEMENT CUT.POLICV-APPLIES?
pISCLAIMER -- . . . • -- .. . r
The permitted verlles, acknowledges and agrees by their signature that 1) If this permit Is for construction or on a dwelling; the dwelling Is/}viii•
be served by potable water. 2) Ownership of this City of Spokane Valley permit inures to the property owner. 3) The signatory is the property
owner or has permisslon 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 revlew at the City of -Spokane Valley Permit Center. 5)' The City 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
Inforrnation may be required to be submitted and subsequently approved before this application can be processed.-
EXPIRATION - - - -
Right -or -way permits Issued between April 1" and September 30' are valid for 30 days'after the date of Issuance, with a one-time 30 -day '
•
extenslon available:' -Right-of-way. permits Issued between October 1" and March 31": are valid until the following April,30`". ---
Applicant Signature:
Date: 3' -/l -/S
Method of payment: ❑ Cash • 0 Check El Visa** 0 Mastercard**
** If paying with credit card, the City will call for credit card information when the permit is ready to be Issued.
PLEASE FAX TO CITY OF SPOKANE VALLEY (509) 688-0037 UPON COMPLETION.
Modified April 14, 2014 s
httd://wwwsookanevalle
orn/f ilestoraoe/ 124/938/210/948/1496/283I/RO W PA.doc
BUFFER DATA i'
RURAL ROADS &. URSA)) ARSENALS 35140' MPH -3557*)..
LONCITUONAL BUFFER 'SPACE :TB
'
SPUD_n?ro 125'.:
ID [35
40
(5'110
55 [50
65`
TO
LENGTH Nea()'.55:
:001250
305
-.1..-
- 1
I
P22eM1e Miln rtmiiembb nny M a woo vMbalff BSA 4 net:
a'Abtio, tle Waage nhas. Mata tractscry bct'b0. a :it M1b o
sPKld nabs and Aro Weasel 0 Dna) b spadfe
SIGN SPACING . X _TEES) (1 )
RURAL ROADS &. URSA)) ARSENALS 35140' MPH -3557*)..
RURAL. ROADS, ((ROAN ARTERIALS. 25fI0�MPN 2COe QI
REsmENTW. & 0usD.ss mSnnCTs
1 UR &VI': SHEETS 25 MPH OR.IE55100*. Q)
ALL MONS ARE AYP Km SLACK ON ORANGE. ()SAXES, OTSIF.RWISE.
I DESIGMATEG. ..
(1)APspacingmay., be adjusted to acpmm0date interchange ramps,
at -grade' InterseWons. and drlvewayp.
(2) This sparing may be: reduced in urban areas to IS readvmy
andltlorG:-
VIN MUMS TAPER', LDiGR1: -.0 (3:30 .. .
SiRWtr.
PAPA Am)
Feely Start VAtt).
25. m 19 40 AS 50 55 50. 05 70.
s
84
.1201 •02
2+0J -:'.'
[ -
�.
I
3.0EViC=,MIMMum SPACTOJ 100.0: IN TAPERS FOR
SHOULDER W01113 LESS MVP 3 FEET
,CHANNELITJNG:DENOE:
SPAGNG' (FEET)
NOTES
1 Protective vehicle Iicolnmended -may be a work vehicle:.
2. When used. device "spacing for the downstream taper should be 2Q O.0
:LEGEND'..
SIGN LOCATION
v v b- .. YFWNNEiIDNG DEVICES=
PROTECTNE:VEMCLE RECOMMENDED
APICAL SHOULDER CLOSURE -LOW -.SPEED' (40 MPH OR LESS)
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