2013, 11-05 Permit App: ROW-2013-0571 Move House*Wane�
,#Talley°
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenter@spokanevallev.orq
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEED 7
RIGHT OF WAY (ROW) PERMIT APPLICATION
0 DRIVEWAY 7 VEMENT CUT (SEE BELOW) ®SIDEWALK
CURB & GUTTER a OTHER 14-DLLSe Vt�yQ_�.
ROAD OBSTRUCTION I NO [ YES ***TRAFFIC PLAN REQUIRED
PROJECT ADDRESS:h 4-5b84- iao3
a5 — /0 ?�,q F• dirt fC v- _
START DATE: it/jayl° (W a n' ANTICIPATED COMPLETION DATE: j/(ap
BUILDING OWNER NAME:
Y
G +4r��_-� 1 hof J ao 13��
' ProleGt ,,r r, E
NAME:
ADDRESS:
CITY: STATE:\
PHONE: FAX:
NU
CELL:
CONTACT NAME:
r.SV PERP.'',!' ut '
PHONE:
CONTRACTOR NAME:
FAX:y l �ZELL: F4 E1- it
11-
6 rerWta Lt p 6 Fcarmt �--�-
MAILING ADDRESS: l 2-1litaatc-.7fh
CITY:�� k,_ct_k4 e
E. -73q
/1/`
PHONE: \- q 4/
STATE:
FAX:
CELL:
CONTRACTOR LICENSE No.: r7 f fTS4r-b C -a. EXPIRES: -02,73A' CITY BUSINESS LICENSE NO.: ko,S m¢J342j
TIER:
POLICY: ✓
BOND/INSURANCE CERTIFICATE #:
(PER SVMC TITLE 10 ARTICLE 2)
SIGNATURE: C.4.1 t 0- e r - Aitt - Jl jyLp�
DATE:
ll(�� Ij�J
****MUST BE COMPLETE IF PAVEMENT CUT****
TYPE OF WORK
CONDITION OF CUT
TYPE OF
REPAIR
EXISTING ROAD CONDITION
Gas
Sawcut
As alt
Depth of Asphalt:
Electric
Grind/-ConcreteDepth
(preapproved onl )
of Gravel:
Water
CATV
Comm.
{ l/ a
Sewer
Other
Effective October 28, 2007 Page 1 of 2
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Right_of_Way_(ROW)_Permit_App_1-11-11.doc
Asphalt (width X length)
Concrete (width X length)
Locate Ticket #:
X
X
X
X
X
X
X
X
X
X
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 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 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
Information may be required to be submitted and subsequently approved before this application can be processed.
Signature
(-kfc,ti orct 'r --
Date:
lk 11 rip
PLEASE FAX TO CITY OF SPOKANE VALLEY (509) 688-0037 UPON COMPLETION
Effective October 28, 2007 Page 2 of 2
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Right_of Way_(ROW)_Perrnit_App_1-11-11.doc
Sil®ka` e
Valley
Public Works Department
Traffic Engineering
11707 ESprague Ave Suite 106 0 Spokane Valley. WA 99206
509,921.1000 0 Fax: 509.688.0261 0 cityhatt®spokanevattey,org
TCP Review
To: Paul Breithaupt
Fax:
Cci.
Re: House Move
From: Ryan Kipp - Assistant Traffic Engineer
Pages:
Date: 10/31/13
The traffic control plan submitted for the above referenced work has been APPROVED AS NOTED
below.
By: _%rn
and p , PE
THIS IS NOT A P RMIT
Notes:
Date: /°/3/70
1. The traffic control plan submitted has been approved for concept only. The contractor is responsible
for determining specific signing and layout as required by the Manual on Uniform Traffic Control
Devices, WSDOT specifications, and Washington State modifications to the MUTCD. All devices
Shall conform to the MUTCD and WSDOT specifications. The City of Spokane Valley may request
changes as warranted by traffic conditions and motorist behavior.
2. The contractor shall contact Carolbelle Branch, Public Information Officer within 24 hours of
receiving this approval. The contractor must provide the location of the work; expected start and end
dates, and dates and times of any road closures or delays. Carolbelle can be reached at (509) 720-
5411 or cbranch o(�spokanevallev.orq, and she will notify the newspaper, school districts, Spokane
Valley police department, and fire dispatch as necessary. Information should be provided In the
following format:
(STREET'NAME) between (CROSS STREET NAME) and (CROSS STREET NAME) will be
(DESCRIPTION OF IMPACT) from (TIME) ort (DATE) to (TIME) on (DATE) for (REASON FOR
WORK). (ADDITIONAL NOTE). For more information on this project, call (CONTRACTOR
NAME) at (xxx-x)ox).
3. See paperwork attached plan.
Project ;!__N7- 013-097/.
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RECEIVED
SE? 262013
CSV PERMIT CENTER
SUB # 1 REV. #
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?LAMING DEPT. (APPROVED
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10309 E. MIS,Stolti
Project # V-:eO 9J^Ia6-0
RECEIVED
SEP 31 2013
_- CgLE_EBMIT CENTER
SUB # � REV. #
IY\ISSI0N MUE
Mary May
From: Ryan Kipp
Sent: Thursday, October 31, 2013 9:23 AM
To: Mary May
Cc: Deven Nickerson
Subject: Mission House Move '
Attachments: Mission House Move.pdf
Hi Mary,
Paul stopped in this morning about a house move on Mission. The house is over 34' wide and 23' high, so I requested
that he get a right of way use permit. I have approved the route and plan. Please see the attached pdf.
Thanks,
Ryan Kipp, PE, PTOE
Assistant Traffic Engineer
City of Spokane Valley
11707 E. Sprague Ave., Suite 106
Spokane Valley, WA
Ph: (509) 720-5016 Fax: (509) 688-0261
rkipp@spokanevalley.org
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