2007, 06-18 Permit App: 07002314 ROW, Repair Water Main1FROa�i PHONE NO. : Jun. 15 2007 11 50RM P1
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City of PERN&TT # PW
SPOKANE VALLEY
UTILITY RIGHT — OF — WAY APPLICATION
AND PERMIT
PUBLIC WORKS DEPARTMENT
APPLICATION
Location of property involved (ar address)
Nome de. timpany ORCEIARD A,V€NUE1R� RiGATIO r71�a riegre '
Trantaksaa
Address of company
8101 E BUCKEYE AVE—SPOKANE WA9` � 926-4563
Contractors Juane ORCHARD AVENUE IRRIGATION DISTRICT 16
Contratxoes address
8101 E BUCKEYE AVE—SPOKANE WA A? 926-4563
Contractors regdstratiou Number Expiration date
Might of War.
Pavcarcot or sidewalk intrusive- its —__ No 1-/--
Intrusive outside of pavement or sidewalks. Yes No
Leugth of cut _ ft_ Depth of cut ftWidth of cat ft.
Direction of cut
.1-23
1 63
Coutiles person MIKE
3iddroes of contact 8101
KLEIN OR GREG BOWMAN
E BUCKEYE AVE—SPOKANE Poa2212 926-4563
Please explain in drtall the d tion of the activity propmed. /Z�,./4/
/Ktt/6 &4* /,V.4 C Ts A/ /-0 4040
r6 CS AVE
�1 hereby authorize the City of Spokane Valley to charge *e feu for this permit to my credit card:
Vias Nun/archatgu
Print name of hailer Signature
PERMIT: Special Conditions
Reatar■tion: Yam.ncnT_Temporary_
Lyne of bar -kill to be cued: gravel _ croaked
LS A COPY OF A lliOND DCPOSI"TED WITH THE CITY OF SPOKANE VALLEY ?
A COPY OF TILE CITY / UTILITY LL 1ULTTY LNSURA.NCE POLICY MUST BE ON
FILE AT THE C1Tl'. •
PERMIT' FEES INSPECTION FEE S
Approved
Public Works Director
R -O- WARP.
JUN 15 2007 11:45
Date
CALL 24HOURS BEFORE INSPECTION NEEDED
Phone 509-688-0036 Fax 509-488-0037
TOTAL PPQE.02 ee
PRGE.01