2007, 06-26 Permit App: 07002404 ROWCity of PERMIT# PW )d>
SPOKANE VALLEY
ITT)LITY RIGHT - OF - WAY APPLICATION
AND PERMIT
PUBLIC WORKS DEPZTMENT
APPLICATION
Location of property involved (or address) / 723 4 i '$5A)v Ac.
Nameofcompany Consolidated Irrigation District #19
Address of company N. 120 Greenacres Rd. phone (509) 924-355
Greenacres, WA 99016
Contractors nazi e-igationr District #19
Contractors address N. 120 Greenacres Rd. pbone (509) 924-355
c,reeraacres, INT7c-9-9 u1.6
Contractors registration Number N/A Expiration date N/A /
`
Right of Way: CO`7 9o9
Pavement or sidewalk intrusive. Yes No ✓
Intrusive outside of pavement or sidewalks. Yes / No
Length of cut W ft. Depth of cut Z ft. Width of cut & ft.
Direction of cut S' -c.c.)
Contact person Robert 0. Ashcra f t
Address of contact N. 12 Q Greenacres fid . Phone (509) 924-3655
Greenacres, WA 99016 /
Please explain in detail the description. of the actzviproposed. e,�a,ace� cu.2-e,_
r hereby authorize the City of Spokane Valley to charge the fee for this permit to xczyxrcditxezd.X
XasKXbllr(effeXXX _Bill above address
l coca iatIcl Signature
PERM11: Special Conditions
Restoration: Permanent Temporary
1), -pc of bade III( to be used: gravel crushed CDF
ISA COPY OFA BOND DEPOSU. ED WITH Tom. CITY OF SPODE 'VALLEY 2
A COPY OF THE CFIY / UTILITY LLABILITY INSUR NCE POLICY MUST BE ON
MLLE AT TELE CITY.
PERrIIT FEE S INSPECTION FEE S
Approved
Public Works Director Date
R - o - W APP,
JUN 21 2007 13:34
CALL 24 HOURS BEFORE INSPECTIONNFP'»ED
Phone 509-688-,9036 Fax 509-688-0037
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