2015, 03-31 Permit App: ROW-2015-0140 ROW I •
Community Development Department
Permit Center (Staff Use Only)
11703 East Sprague Avenue, Suite B-3
Sffolane --- Spokane Valley,WA 99206
Tel: (509)688-0036 PERMIT NUMBER:
V
a Fax: (509) 688-0037 PERMIT FEE:
germitcenteresookanevallev,org
alleY
RIGHT OF WAY (ROW) PERMIT APPLICATION
El APPROACH Ei PAVEMENT CUT (SEE BELOW) El SIDEWALK
El CURB & GUTTER 111 WORK THROUGH MANHOLE 0 OTHER
ROAD OBSTRUCTION ID NO M YES (if yes, complete the following)
• % of street or # lanes that will be obstructed:
• Length of time street will be obstructed:
E4. 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 D Pre-Approved TCP Proposed:
PROJECT ADDRESS: /9500c. Wellesley A./e. PARCEL NUMBER:
APPLICANT'S JOB #: /35733 LOCATE TICKET# /50494..9"
START DATE: 4 /-2p/5--- ANTICIPATED COMPLETION DATE: 5-/-.2.vs
PROJECT DESCRIPTION: — i,
/tench //joir go' FL Ac. /40-0// 2 " pil6 •- )
(orocG5t.
PROPERTY OR BUILDING OWNER INFORMATION (IF APPLICABLE)
NAME:
MAILING ADDRESS: CITY: STATE: ZIP:
PHONE: FAX: CELL:
CONTRACTOR INFORMATION gji 1-, (_-L,fn 6 a50- (A c
NAME: 3 e foe, 60M fYit.4 el;C:a4;0115 _
MAILING ADDRESS:3oiti At, na,,, 0 CITY: _Vhas)t' licillei STATE: IniA ZIP:
PHONE: 509 53.2 - El 30 `Ei FAX: 5 oij-53.2- 6515 CELL:
CONTRACTOR LICENSE NO. bO I CloZ 1 I 9 1 EXPIRES: CITY BUSINESS LICENSE NO.: '.1 Iv
BOND/INSURANCE CERTIFICATE# (per SVMC Title 10, ArtIcle 2):
CONTACT NAME: / i
i T2 A breilrgi n PHONE: .20‘ - 'e3- 7/S7
--1
Qr-r"' T-Lit '')"•:,r)
fl)C:%.r C.:. v ILL,
CSV PERU 1 CENTER
MAR 1 2015
,Project# RoV-lo lc - 0140
iName 77 75
Modified April 14, 2014 i Subittoi /. _ _ _ ___ Page 1 of 2
g• A 1.s.• .n- .1 - .or. ft- ora.e 124 • : 10 *4: 4'. : ts •A.doc
**** 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 f
(width) x (length) 3 X 6
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. 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 1"and September 30th 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 and March 31"are valid until the following April 30"'.
o
Applicant Signature: c / / Date: 3-30 20/5
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
h tto://www.svoka nevallev.ora/fi lestoraae/124/938/210/948/149§/2831/RQ W PA.doc
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BUFFER DATA siolv SPACINO 4 X(FEED (1)
0
IIIINIMLAR TAPER LENGTH e L(key_ ,
ID. 0
z-
i RURAL ROADS a URBAN ARTERIALS 15/40 MPH 35at Posted Speed(rept) 0/
r4 N ) LONGITUDINAL BUFFER SPACE = B FUJRAL ROADS,URBAN ARTERIALS ,,,,,mpii
25 30 EMI 1
. , 35 40 4S 50 50 60 65 70 , II
70.
°
SPEED Swill 25 30 35 40 45 50 55 60 65 J TO Re°1°°111.4.°illjaNE°S CNSTRICT° 2D7*III 11110111101 120 ell 210 111111111111111111111 •4
62
URDAN STRte TS 25 MPH OR LESS 100s(7)
C2 LENSTH I test) /55 200 250 305
L 10 0 00 204 21011111111111111111 .
..... -i _ AU.SIGNS ARE Ar a er MACK ON ORANGE UNLESS OTHERVASE
..N4.
AS Z
OES/ONATED
..._ Protective veritle moarrreseded-mei be a wars rabid&Its THA la not
available OW indecave ramie armee erstaglasty located in tee 500b 0 DEVICES MINIMUM SPACED IVO.C.IN TAPERS FOR
SHOULDF_R IMOTHS LESS THAN 0 FEET
ri mew when end no roe Weed 441)444 4 NN4itbd, (1)All Spacing may be adjusted to accOmmodate interchange ramps,
0-grade Intersections,and drNeways.
0
(2)This spacing may be reduced h urban areas lo re roadway
Z. 1 cendltrons.
0
0
CHAINEUZINO DEVICE SPACING (FEET)
io
MPH TAPER TANGENT
.S.
35/40 30 60
de
20 40
Of ,
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SIMADER
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NOTES
1.Protective vehicle recommended -may be a work vehicle. CO
2.When treed,device spacing for the downstream taper should be 20.0.C. 0
0
A
LEGEND
-•
a
q SIGN LOCAMN
ta a a e CRANNELIZING DEVICES
N
(CI
ID PROTECTIVE VEHICLE -RECOMMENDED
TYPICAL SHOULDER CLOSURE -LOW SPEED (40 MPH OR LESS)
Napo
1:4
; TCP 5
(0
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fr)
'44
1
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1 40
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