2006, 01-04 Permit: 06000020 Road ObstructionSpokane
valley
BUILDING DIVISION
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Site Information Project Information
Site Address: 2100 N FIOUK a SHANNON AVE
Parcel Number: 99999.9999
Subdivision:
Block:
Lot:
Zoning: UNK Unknown
Owner: UNKNOWN
Address: UNKNOWN
UNKNOWN
Building Inspector: KEVIN SEVERANCE
Water Dist:
Project Number: 06000020 Inv: 1 Issue Date: 01/04/2006
Permit Use: ROAD OBSTRUCTION FOR PLACEMENT OF BURIED
CABLE
Applicant: QWEST CORPORATION
904 N COLUMBUS S7'
SPOKANE, WA 99202 Phone: (509) 455-2101
Contact: QWEST CORPORATION
904 N COLUMBUS ST
SPOKANE, WA 99202 Phone: (509)455-2101
Setbacks - Front: Left: Right: Rear:
Jurisdiction:: QWEST COMMUNICATIONS CO
Group Name:
Project Name:
Permits
Right of Way
Contractor: UNKNOWN
License 4: UNKNOWN
ROW - RD OBSTRUCTION $70 00
'total Permit Fee: $70 00
FOR RIGHT OF WAY INSPECTIONS CALL
(509) 869-5373 ENGINEERING
Payment Summary
Total Fees AmountPaid AmountOwing
$70.00 $0 00
$70.00
Tran Date
01/04/2006
Processed By: JANSSEN, CHRIS'T'INA
Printed By: Main. Jodi L Page 1 of 1
Receipt N Payment Amt
3946 $0.00
PERMIT
FROM US WEST
IL;
SDO a' ''
`1
(TUE) 1. 3'06 16 48/ST. 16 47/NO 4862376145 P 2
tra
Call 24 hours before inopocUun required
Phone 509.655-0036 Fax509.5SS-0037
DEPARTMENT OF PUBLIC WORKS
Anticipated start date Permit i✓ PW
'' /I ROW CONSTRUCTION PERMIT
N2
Location of properly 1rn.121/1.14 K t. Sha 1rV4 ruj�
(Address/Parcel #, if available)
Applicant Name i2,0V5J- (.l•:ri :'7j/tOtrt
Andress (0.1 r(/ C'k'trilU; .fYkWr_f;)O Phone Si1h'4I;J7
Contractor's Name
Address Phone
Contractor's Rog# Expires
PROJECT DESCRIPTION (Prorate rite sketch or pian as necessary for clarity)
Sower Connection
Curb & Gutter
1 vi Cable/Conduit
nOther
T
Pavement Cull Dimensions
Driveway
Gas Installation
Sidewalk RepairiConstruction
Bond'ir surance cent6m5on must oe on Re tart :ne Cry Band k
SPECIAL CONDITIONS: 01:761= Itiif iG 'P.t e Sauf* -j,'7e Qrr G '%]Y.(r]%ev;
r
Perm ince 5lgna:ure.r;+j>ti'%. !n�:�l'm;i/n Approved
II eare,y a•nno, ft :ne Cey of Sonlane Valles re charge tx fee for tris oermu to my C ami car,.
Ca:d r.
Erolratlon Data
Name at Holacr Sene:ire
Fees Paid$
(Application)
(Inspection)
Date !nit
In aceeion to the permit application fee of S i S CO (utility) or :125.03 (ccntLnenonl, c.spoclion on
each permit sat! ce odled to tho pennitme a: a rate of 550.00 ocr hour wio a S2E CO (IQ hour)
minimum. Fermr.:ea signature conatitutes an agreement to (nese :erns an. _todel.ns
Work completed satisfactorily (Signed) Date
Permit not vstid until One -Call Notification Ticket k en trred here
SON 02 2006 1E438
15094552184 PRCE.02
6.47/NO ,1862876!45
CONF U-.T.AL JE-0LDSC A:45. 5.10'10':r "M_EL TO US 'Wt T
I.IPLO` E5 4 rc = liar 1 059W
EXISTING FASO/EMI"
PROPOSED TEL
CITY OF S
DO
'KA N'` VALLEY PEP MIT
R/W
R/W
NOTE:
TRENCH [0 BE 36" DEEP
E SHANNON AV
C'thRB
150' AT 35' DEEP
Qwest
25 NI V
-' /, _
F JC I_l,-
10
LJ
L1
R
2
REMAR<S:
t
NORTH
all.
Ill ....
DENED BY: DLHUfCf-IISON
ISIG
A EPHONE:5094552757
TAPER CODE:
PI AT REF:
11313:52'N LA 60
GEO CODES AJ7
`A 2
C CILLI: ,;;�K KNM'' 22
ISS#: ISS DATE:
R/W
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