2015, 08-10 Permit App: Row-2015-0511 Right of WayZSN '°N WdOS:6 SI06 '0l 'SnV awil paAI;Dq
Community Development Department
Permit Center (Staff Use Only)
11703 East Sprague Avenue, Suite B-3
C'IlaTY OF70 000^%M0tU Spokane Valley, WA 99206 _ PERMIT NUMBER:
jn Tel: (509) 688-0036
Fax: (509) 688-0037 PERMIT FEE:
OValkyx �ermitcenter@sookaneyalley.or-
RIGHT OF WAY (ROW) PERMIT APPLICATION
E] APPROACH ❑ PAVEMENT CUT (SEE BELOW) X SIDEWALK
Q CURB & GUTTER WORK THROUGH MANHOLE [] OTHER
ROAD OBSTRUCTION (] NO X YES (if yes, complete the following)
of street or # lanes that will be obstructed: 1
Length of time street will be obstructed: 2
b 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 Pre -Approved TCP Proposed: SV —TC - 106
PROJECT ADDRESS 17 N. BOWDISH RD. PARCEL NUMBER:
45163.0558 _
A_PPLICANT'S JOB #• LOCATE TICKET #
START DATE: 8/12/16 ANTICIPATED COMPLETION DATE: 8/14/16
PROJECT DESCRIPTION: MJM IS GOING TO DEMO 1 BUILDING ON -SITE THAT IS ONLY ABOUT 3 FEET AWAY FROM
THE BACK OF THE SIDEWALK THAT RUNS PARALLEL TO BOWDISH ROAD.
PROPERTY OR BUILDING OWNER INFORMATION (IF APPLICABLE)
NAME: OREILLY AUTO ENTERPRIZES LLC
MAILING ADDRESS: P.O. BOX CITY:SPRINGFIELD STATE: MO zIP:65801-1156
PHONE: NA FAX: NA CELL: NA
a - -
CONTRACTOR INFORMATION
NAME'MJM GRAND INC.
MAILING ADDRESS: P.O. BOX 2087 CITY: AIRWAY HEIGHTS STATE: WA zip: 99201
PHONE:509-244-733 FAX: 509-244-4725 CELL: 509-370-0620
CONTRACTOR LICENSE NO.: MJMGRI`126BG EXPIRES: 5/9/16 CITY BUSINESS LICENSE NO.: NA
BOND/INSURANCE CERTIFICATE # (per SVMC Title 10 Article 2): NA
CONTACT NAME: KATHI HARDING / JAY SCHUETZLE PHONE: 509-244-4733
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****IF PAVEMENT CUT, COMPLETE THE FOLLOWING ****
NATURE OF WORK:
Gas
Electric
Water
CATV
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) Ail 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.
EXPIRATION
Right-of-way permits Issued between April lu and September 300 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 I& and March 3V' are valid until the following April 30th.
Applicant Signature: Date: 8-10-15
Method of payment: ❑ Cash ❑ Check X Visa** ❑ Mastercard**
** If paying with credit card, the City will call for credit card information when the permit is ready to be issued.
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