2014, 10-13 Permit App: ROW-2014-0562 ROW I II
E�NROM HAWK INS EXCAVATING PHONE NO. : 924 9025 Oct. 13 2014 12:23PM P1
■
Community Development Department
Permit Center (Staff Use Only)
Cfr1( 11703 East Sprague Avenue, Suite B-3
•Spokane Valley,WA 99206 PERMsr NUMBER:Tel: (509) 688-0036
V al 7 ���� Fax: (509)688-0037 PERMIT FEE:
40/0 yermltcenter(hlsaakanevalley.org
•
RIGHT OF WAY CROW) PERMIT APPLICATION - •
•
Et DRIVEWAY PAVEMENT CUT (SEE BELOW) Il SIDEWALK
1 CURB & GUTTER t OTHER
ROAD OBSTRUCTION NO A Lel YES ***TRAFFIC PLAN REQUIRED
PROSECT ADDRESS: l /? ce. J o2
START DATE: /p—/S—!% ANTICIPATED COMPLETION DATE: /O-/6-i i
BUILDING OWNER NAME: pa y e v«/e2_
n,; t /Oa)
NAME: RECEIVED
ADDRESS:
CIT,►: STATE: CCI 1 L 014
PHONE: . FAx: CSv4M /11T CENTER
CONTACT NAME: SUB j r3:V.
PHONE: FAX: -----
CONTRACTOR NAME: , L. bu w/iri'!/
MAILING ADDRESS: Y.72 /✓(,4'C•a
_CITY: .5707 .r(Q N e STATE: -7-e./Ce ZIP: 9 97D 6
PHONE: 92 V 9>7 5 FAX: 9,2 V 9',U2 s— CELL: /`-' Ere)3 s--
CONTRACTOR LICENSE No.: cF/./7/f} E EXPIRES: S-3/—/6 CITY BUSINESS LICENSE NO.:
TIER:
POLICY:
OND/INSURANCE CERTIFICATE #:
(PER SVMC TITLAir 10 ARTICLE 2)
•
SIGNATURE: r, DATE: /0- - //
/ :Ic:ica *Iul1I I DC f( P.AD: CTC TC DMIrMrmT rI IT****
TYPE OF WORK CONDITION OF CUT TYPE OF EXISTING ROAD CONDITION
REPAIR
Gas Sawcut Asphalt Depth of Asphalt:
Grind Concrete Depth of Gravel:
Electric (preapproved only)
Water
CATV
Comm. •
Sewer j/ 54ui cul- o5P4,l7 _ -
Other
Effective October 28,2007 Page 1 of 2
/� 'ar270 ' 10C1n"t E-11110a/938/210/948/1496/Right_of_Way_(ROW)_Permit_App_1-11-il.doc
Received Time Ocf. 13. 2014 '10;�55AM No, 1107
FROM : HAWKINS EXCAVATING PHONE NO. : 924 9025 Oct. 13 2014 12:24PM P2
Asphalt (width X length) Concrete (width X length) Locate Ticket#:
/ D X 'O X X
x x x
x x x
•
x x x
•
PISCLAIMER • •
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 Inure 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.
Signature - -_._., Date: /0-- 5--/
PLEASE FAX TO CITY OF SPOKANE VALLEY (509) 688-0037 UPON COMPLETION
•
•
57-4 e T 2N rel 6eT
C L vs�� s e 4 os e�
...- •
•
•
•
1/41.1
�i� •
•
•
Effective October 26, 2007 Page 2 of 2 •
hrtn•gwwf • cnnkaro„allev nrn/fIiwctorane/t 74/938/210/948/1496/Right_of Way_(ROW)_Permlt_App_1-11-11.d0c
Received Time Oct. 13. 2014 10: 55AM No. 1107
■
B■ f1M : HAINTNS FXJi
CUPTTNG _„••.••RHONE,JJCt„.:._424_PER.5_... flr.t._ AR 2114 A7: SAM P1
Permit Center
Spokane (Staff use only)
11703 East Sprague Avenue, Suite 0-3
OFSpokane Palley,WA 99206 PERMIT NUMBER••
Tel: (509)688-0036 � 7] / /mo0
l r Fax: (509) 688-0037 PERMIT FEE:
p@Cmltcenter(&�sookanevallev.orq
4000.Val
RIGHT OF WAY (ROW) PERMIT APPLICATION . •
•
I DRIVEWAY .`' PAVEMENT CUT (SEE BELOW) IR SIDEWALK
al CURB & GUTTER L OTHER
ROAD OBSTRUCTION E NO tE YES ***TRAFFXC PLAN REQUIRED
PROJECT ADDRESS: 1 S.?/2 ✓ •
START DATE: /p-,i S�/y ANTICIPATED COMP ETION D- : - , /_
l�/�
BUILDING OWNER NAME: Pimisra. e %//0(..e/ 2 ./P `� y"" rr=��-�
t` , IVED
NAME.
ADDRESS: CCI 0 8 2014
P:
. CSV P_HIvZI1(T CENTER
CITY: STATE:
PHONE: . ' FAX: ' CE :
• . .-
REV. =
CONTACT NAME:
PHONE: FAX: CELL:
CONTRACTOR NAME: , L, /Yet (A/.41.14/.5
MAILING ADDE*V /
ADDRESS: � � S 722 NC),[ ez
J
CITY: . QR /v a STATE: Ce ZIP: c
PHONE: '2 V 9v Z S FAX: 92 / U Z S` CELL: /�/` F()3 G-
CONTRACTOR LICENSE No.: 7L.Ai„4 t4',jay EEXPIRES: S-3/-/cS CITY BUSINESS LICENSE NO.:
TIER: -
POLICY:
BOND/INSURANCE CERTIFICATE #:
(PER SVMC TITL 10 ARTICLE 2)
SIGNATURE: X ,h DATE: /0--- S;- /
****MUST BE COMPLETE IF PAVEMENT CUT****
TYPE OF WORK CONDITION OF CUT JIFF OF EXISTING ROAD CONDITION
REPAIR
Gas Sawcut Asphalt Depth of Asphalt:
Electric Grind Concrete Depth of Gravel:
(preapproved only)
Water
CATV
W
Comm. -
Sewer L/ SSIw Cte7 09P-(a L7
Other
^
•
Effective October 28, 2007 Page 1 of 2
h.+..• /,...., ^1-a^���ylie""^e^'filpstc'-'" 7,a/938/210/948/1496/RIght_of_Way_(ROW)_Permit_App.1-11-11.doc
Received Time Oct. 8. ' 2014 6: 27AM No. 1085
FROM : HAWK INS EXCAVATING PHONE NO. : 924 9025 Oct. 08 2014 07:56AM P2
Asphalt (width X length) Concrete (width X length) Locate Ticket #:
/ D X D . X X
x x x
x • x x
x x x
' 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
hoeartidarl hr,nnrahla tAlwPian 1)P1..101..,.4.IA nC•r.r.•rrr•,...a cn..r.,...,v�n..�. n i.r........ .��r_��� 'r - -) -.r..- .r.- _ -.
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.
Signature Date: /0— -/ 5/
PLEASE FAX TO CITY OF SPOKANE VALLEY (509) 688-0037 UPON COMPLETION
•
574 ee rs 7'''-1 eeT
C G Se, C L .,s e c -
. .
•
•
•
•
.
5-3/
•
I
•
•
J
Effective October 28,2007 Page 2 of 2
htto://www.spokanevalley.org/fllestorage/124/938/210/948/1496/Right_of_Way„(ROW)_Permit_App_1-11-11.doc
Received Time Oct. 8. 2014 6: 27AM No. 1085