2014, 11-13 Permit App: ROW-2014-0661 Sewerline Tapv 13 14 11:47a Vietzke
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Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) :3:;:7:-]3.11.=.
Fax: 15)01
16Valley' _ -..:'r1
5092440596
PERMIT
NUMBER:
(Staff Use Only)
PE RMaT
FEE:
p.1
RIGHT OF WAY (ROW) PERMIT APPLICATION
Project # R��oti' 7 /' -O66 (
RECEIVED
NOV 1 3 2014
CSV PERMIT CENTER
APPROACH
BELOW)
CURB & GUTTER
MANHOLE
PAVEMENT CUT (SEE
SIDEWALK
WORK THROUGH
kfkr
ROAD OBSTRUCTION NO � yes, complete the following)
% of street or # lanes that will be obstructed: I�
• Length of time street will be obstructed: 330' liCLY
SUB #L_ j REV.#
i=>If work doses more than 50°/0 of a local access street, or doses any portion of an arterial street,
then a TRAFFIC PLAN IS REQUIRED Pre -Approved TCP Proposed:
PROJECT ADDRESS: n02 U441y
APPLICANT'S JOB #:
START DATE: J 1— 17 '2Q 14
PROSECT DESCRIPTION:
(dL
n
Y n V4 S -124.7v -_v -
PARCEL NUMBER: LiS / 84, I/JLI
LOCATE TICKET # ) Lf 3 2.J09
ANTICIPATED COMPLETION DATE: 1 2c) `2C tE
PROPERTY ORUILDING OWNER INFORMATION (IF APPLICABLE)
NAME: C"c ‘.& 'j ii.Vc
MAILING ADDRESS: V g--62 • - va i STATE:
PHONE: '2-c\ t4 r 8-v
FAX:
tk" up: 01 ct21Z
CELL:
CONTRACTOR INFORMATION
NAME: (i ..% xC.a ua.�.-.n--r,�q ,` _
MAILING ADDRESS: S t)-o1,r C 6L ' QTY: NeU,g1 1
PRONE: 5271- ?j`72.,q1-1*---gV 5-01{ V 7 FAX: � ` 2.9/1-05-%
SrATE:q7P:
CONTRACTOR LICENSE NO.: kit e\ zei, I2A Y EJC
CELL:
qo i
pri-sm
PIRES: - 2(�`5 QiY BUSINESS LICENSE NO.:
BOND/INSURANCE ceramic/err # (per SVMC Title 10, Article 2):
Received Time Nov.13. 2014 10:12AM No.1241
Nov 13 14 11:47a Vietzke
CONTACT NM.IF:
lig 01.1A SLS
5092440596 p.2
Pt$0NE: lc -a°1 -T314-036
**** IF PAVEMENT CUT, COMPLETE THE FOLLOWING ****
NATURE OF WORK: (circle
one)
Gas
Electric
Water
CAW
Communicate) Sewer her
TYPE OF CUT/REPAIR:
(circle one)
phalt
Gravel
Concrete
Other
SIZE OF CUT
(width) x (length)
��II
1--f"C 10 1X IS
STAFF TO COMPLETE:
ROAD TIER:
APPLIES?
PAVEMENT CUT POLICY
OISCLAXMER
The perm.ed verifies, advmowledges and agrees by their signature that: 1) if this permit is /or construction or on a dweJing, 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 hes permission to represent the property owner In this transaction. 4) AY construction Is to be done in full compliance with the City of
Spokane Valley Development code. ftefererced codes are available for review et the Cty of Spokane Valley Pern t Center. 5) The Gty of
Spokane Valley perrnit is not a permit or approval for any videtion of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be required to be submitted end subsequently approved before thts application can be processed.
EXPIRATION
Right-of-way permks Issued between April 1 and September 3e are valid for 39 days after the date of issuance, with a one-time 30 -clay
extension available. Rieht-of-way permits issued between October 1 and March )1, are valid untll the following April 30�.
Applicant Signature:
Method of payment: Cash Check
Masterca rd'"
Date: , -/3-20'l L�
*'" If paying with credlt card, the City will call for credit card information when the permit is ready to be issued.
PLEASE FAX TO CITY OF SPOKANE VALLEY . UPON COMPLETION
R.,4..d 4n 42014
Received Time Nov. 13, 2014 10:12AM No, 1241
Nov 13 1411:47a Vietzke
5092440596 p,3
-2,014.-O4/
COMPANY NAME: 1,4 -Q -
LOCATION OF CLOSURE: e E-0 ? F. w ll e,/ ky a y
DATE OF CLOSURE: 1 — 201
REASON FOR CLOSURE: S'?A'cll
TIME UNTIL COMPLETE RESTORATION: 1'1—La— 9
RECEIVED
r7
NOV 1 2014 \\I
PERMIT CENTER
UG HTED BARRICADES ARE
RECOAIMENDED AT ALL TOES
REQUIRED IF OBSTRUCTION IS LEFT OVERNIGHT
4 DETOUR SIGNS ARE OPTIONAL
ON LOCAL / RES STREETS
.4:r(n eNi
OLISttil A H1
i
01 'J
4350x1 VW
TYPE III BARRICADES
ARE REQUIRED (TYPJ
ROAD
CLOSED
/ff////f/i
ROIL O OS'EED
THRU TRAFFIC
_r( COj-A/e-r\ I ,�.an111:3w
TYPICAL SIGNAGE FOR ALL OPTIONALROAD CLOSED •LOCALTRAFF ONLY"
APPROACHING SIDE STREETS
1-----100' .1 1001
* Contractor must resolve all local
access and safety issues.
AH barricades, cones, and signs must
be in accordance with the latest edition
of the Manual on Uniform Traffic Control
Devices (MUTCD).
Flaggers must be State Certified, must
follow MUTCD guidelines, and must use
and wear safety equipment as required.
Drawing Not to Scale
REV 7/21105
REQD WHEN USING STEEL PLATES
1
100'
100'
•
Ti . NTROL PLAT
Road Cosure - Residential / Local Streets
Received Time—Nov. 13. 2014-10:12AM No, 1241