2015, 03-26 Permit App: ROW-2015-0138 Shoulder WorkCommunity Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcen er@spokanevalleY,orc
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
RIGHT OF WAY (ROW) PERMIT APPLICATION
1 APPROACH PAVEMENT CUT (SEE BELOW) SIDEWALK
CURB & GUTTER ] WORK THROUGH MANHOLE OTHER
ROAD OBSTRUCTION NO YES (if yes, complete the following)
wo,-I, % of street or # lanes that will be obstructed:
�1 Length of time street will be obstructed:
c* 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 IM Pre -Approved TCP Proposed:
PR03ECT ADDRESS: CA6/1 S' IyeWPr" I PARCEL NUMBER:
APPLICANT'S ]OB #: LOCATE TICKET # 15'OS91 ect
START DATE: y -L a015- ANTICIPATED COMPLETION DATE: ,5-1--.2015
PR03ECT DESCRIPTION: , , 11 pvc -, /
or
A,
PROPERTY OR BUILDING OWNER INFORMATION (IF APPLICABLE)
NAME:
MAILING ADDRESS: CITY: STATE: ZIP:
PHONE: FAX: CELL:
CONTRACTOR INFORMATION S iI � oM6a4fi 4 j/e_
NAME i1G0 C .4wlMutrtiL{1 ,001
MAILING ADDRESS: 2�Ci/ y 1!?t t CITY: Ve,Per STATE: j. ZIP: J ?2/1)
PHONE: 509 _ $3 - (:UjjYjGC 30 FAX: � '� 6 S CELL: L, j
CONTRACTOR LICENSE NO.: � %c % I I Li 5 � EXPIRES: � CITY BUSINESS LICENSE NO.: Ff,{�(_�' 0il14 Pj
BOND/INSURANCE CERTIFICATE # (per SVMC Title 10, Article 2):
CONTACT NAME: I foCC 8 enn�;n PHONE: O — 3- 7c/5I
i�✓1�'-_?C1l�-Ci1��
Modified April 14, 2014 Page 1 of 2
htto://www.sookanevalley.Qrq/fllestoraag/`124/
2
**** IF PAVEMENT CUT COMPLETE THE FOLLOWING ****
NATURE OF WORK:
Gas
Electric
Water
CAN
Communication
Sewer
Other
circle one
TYPE OF CUT/REPAIR:
Asphalt
Gravel
Concrete
Other
circle one
SIZE OF CUT
width x (length)
STAFF TO COMPLETE:
ROAD TIER: PAVEMENT CUT POLICY APPLIES?
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 Inures 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. S) 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.
EXPIRATION
Right-of-way permits Issued between April 1'l and September 30W' are valid for 30 days after the date of issuance, with a one-time 30 -day
extension available. Right-of-way permits Issued between October Su and March 311t are valid until the following April 30th.
ature:
Date: az e 2o/ 5'
Method of payment: ❑ Cash ❑ Check ❑ Visa** ❑ 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 Page 2 of 2
httc)//www sDokanevallgy,orcl/filestoraga/124 9 8/210/aaa/1496/2831/ROWPA doc
Q
(R,25
1520
5120 151,26 —T�
T X115 1
F 25TH AVE
�
BPI ,, I 93
—. —W — — Gy
10 1
I
15120 5 Z6 Ac
2615
15212 1 t 15 0
CONSTRUCTION NO�TC-
TRENCH 441'/P3-625;
TIE INTO 14-4 TAP:
SPLICE PER 14'SN;REPWR
JT# 152239
VETIF IED 1-7+,09
PER CHEST, d
15310�, 15320
-------------- T-
1,5309 �� 153-5
3 5 3 0
ENK-�
ONTW
ocl 0� 102
— 0`4
-fie 4 E. 26T H T
C
V 5 L7
1 - 5308
15314 15320 5"0"
NEWER "All 261.1
260\ 9 LNE E "SION
Ln
A A
0; 153'
5204
152-12
z
1, 15220
15,122
2
15205
5
15223
-1510,
51 115
51- 23
fl, 1
t
26TH At,
PROGRFS
J-#54502
I
105
j
—117l'—
4
oc,
r-
t 02'
14
------
2
E
26TH
10 1
I
15120 5 Z6 Ac
2615
15212 1 t 15 0
CONSTRUCTION NO�TC-
TRENCH 441'/P3-625;
TIE INTO 14-4 TAP:
SPLICE PER 14'SN;REPWR
JT# 152239
VETIF IED 1-7+,09
PER CHEST, d
15310�, 15320
-------------- T-
1,5309 �� 153-5
3 5 3 0
ENK-�
ONTW
ocl 0� 102
— 0`4
-fie 4 E. 26T H T
C
V 5 L7
Trenc /50r e 9H 51 R
to 1,1151r, It .2" PV6 -
_3
-47-1-5399 1, ' d
FF
14"o
D
wk.
M.
ms
1 - 5308
15314 15320 5"0"
NEWER "All 261.1
260\ 9 LNE E "SION
JT# 1 52'
A A
0; 153'
2
Trenc /50r e 9H 51 R
to 1,1151r, It .2" PV6 -
_3
-47-1-5399 1, ' d
FF
14"o
D
wk.
M.
ms
BUFFER DATA L
LONGITUDINAL BUFFER SPACE = 8
SF'ECO OPW ZS 30 35
40 45 50 55
60
65 1 TO
LENGTH (teed 155 1 200 250
305 - -
-
.
Pima VINs. nleeneeseefee -may he a work widde. Na TMA bra
IWYbN Ole pralacNe
SON SPACING X "n(1) MIN" TAPER LENGTH : L (NeU I:
RURAL ROARS i llftaAN ARTERIALS 35 140 MPH lso's s��, PeMed Speed 0*D6)
RESCOMAL
i WSNM omit lm 25130 MPH 200'! Q) RWF YAM7S 30 3S 40 AS SO SS 60 65 70
Unam STs 15 am (M LSSS ,0 _ (?) 0 M 120 N32 210 .
j ALL SIGNS ARE 46-x 4e' SLACK ON ORANGE U14L n Ofl1 MSE 10 105 150 26t Z10 _
p DESIGNATED,
3 DEVICES WWWSPACED taO.C. M rAP— FOR
gr4 W W0110 ed e0 nM
end dwm M ep0Cp4sd —be gurAv4sly d tT Dr UMe Cf SHOULDER WIDTHS L'W THAN S FEET
i1i��I+g m" be adjusted to acearlrrlodatr irltercharge ramps,
*trade 11terserd50ft.OW drtveways.
(2) Tt6 ay be reduced In urban aeas t0 fd roadway
CHANNELONG DEVICE SPACING (FEET)
MPf1I TAPER TANGENT
35140 30 60
K2a1 N2,.5
i
LEGEND
b M> LOCATION
o a a CHANNELONG DEVICES
L PRMcTr4E vmcm-R6CONalENow
C NOTES
i
i
1. PrOISCO e W Ade MC01MMWM - may be a work vehicle.
2. When used. device spa0)ng forte down*esm taper should be 20' O.C.
i
I
TYPICAL SHOULDER CLOSURE - LOW SPEED (40 MPH OR LESS)
TCP 5