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2007, 06-04 Permit App: 07002082 ROW Project Number: 07002082 Inv: I Application Date: 6/4/2007 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: ROW-CUT INTO STREET TO CONNECT Contact: TODD FOLSOM UTILITIES 10 X 10 CUT Address: 509 N SOMMER RD C-S-Z: SPOKANE VALLEY,WA 99037 Setbacks:Front Left: Right: Rear: Phone: (509)499-0638 Group Name: I. Site Information: re. Tib^w,rC -w,m'ar','."YR"' -"��i �"?." td�'pi;.�Su,+ "`.v�#d0.•., 61 �»-.m':Yi&i;wk'm'" '-:;*r:=a..... =` . Plat Key: Name: VERA ',istrict: East Parcel Number: 45231.1508 Block: Lot: A SiteAddress: 15117 E 6th VE Owner:Name: TOD 4 FOLSOM Address: 5091SOMME"CT Location::CSV SPOKANE V.i LEY,WA 99037 Zoning: UR-3.5 Urban Res del ia13.5 Water District: 010 VERA - ._,,•,. Hold: ❑ Area: 39,210 Sq Ft Width: 0 Dept"tt^• t` Rig Of Way(ft): 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 / Review Information: - £ Review a Bldg Plan Review ,�4 Released 1 PW Concurrency-Tffic Relea�dBy: .. ,L,4q Vq Permits: __ �. _. ._ nom mre : ,.,.... • .. \ Right if Way Contractor: JEM CONSTRUCTION , Firm: TQDD FOLSOM Address: 509 N SOMMER RD Phone: _ VERADALE,WA 99037 Item Description Unix Unit Desc I Fee Amount ROW-PAV)~''CUT OBS NO WIN 1 SELECT i $160.00 ROW-TRFC CTRL PLN REV 1 ELECT i $50.00 Permit Total Fees: $210.00 Operator: jmm Printed By: jmm Print Date: 6/4/2007 Project Number: 07002082 Inv: 1 Application Date: 6/4/2007 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Right of Way $210.00 $210.00 $0.00 $210.00 $210.00 $210.00 $0.00 $210.00 Disclaimer: Submittal of this application certifies the owner(or person(s)authorized by the owner)has both examined and finds the information contained within to be true and correct,and agrees that all provisions of laws and/or regulations governing this type of work will be complied with. Subsequent issuance of a permit shall not be construed to be a permit for,or an approval of,any violation of any of the provisions of the code or of any other state or local laws or ordinances. Signature: Operator: jmm Printed By: jmm Print Date: 6/4/2007 )" , c 11; , I\ \' I' )I PERMIT NUMBER'--Zc S ,Tn„ Permit Center �� Ir= `'� pokane 11703 E Sprague Ave, S 3 Spokane Valley,WA 99, 0 ; „,1,,i n " �,, PERMIT FEE: Q) Va11ey4 (509)688-0036 FAX:(50.88-009 www.spokanevalley.org r ;) i ` Community Development 1'�'�l ��'_' ROW Construction l'_1 -2 01_1 nriveway , Pavement Cut **(see below) Permit Application ❑ Sidewalk ❑ Curb & Gutter ❑ Other Road Obstruction ❑ No ❑ Yes (traffic control plan required) FKUJt U I ADDRESS /51/7 / C. ,- Ove START DATE 5 A, __ o7 C1 ANTICIPATED COMPLETION DATE .117_627 Building Owner: / Contractor: Name: '77."../4,/ /5a, Name: J J g/ ci tz.o/J •G C Address: 509' ,4i' 5 ,.rt.titet / Q - Address: • �` City: 5�pqta„e Vet// 7 State: /4 119- City: State: Zip: Phone: 5i2 -9'2.2.-:_6-7f7 Fax: 572.19,--679/ Phone: Fax: Contact Person Contractor Lic No:jEArOcL , i• a ate: 341#5,0/ Name: 'ThC�e./ l'#,-)7 City Business Lic.No: Phone: /9 —l,963 • Tier Policy **MUST BE COMPLETE IF PAVEMENT CUT** Type of Work Condition of Cut Gas ✓ Sawcut Electric ✓ Grind(pre-approved only) Water ✓ 14(2 575^e e 7` ' C-/�./I ec7` /0 Communications c?5/ e/P -?i 1-'C � t` 'e, Sewer Other Type of Repair Existing Road Condition Asphalt ' Depth of Asphalt 3 'I Concrete Depth of Gravel Asphalt Concrete Locate Ticket# 7dg' e7 0 0 tillidth Length Width Length X lOt X X X X X BOND/INSURANCE CERT # (PER SVMC TITLE 10 ARTICLE 2) Signature Date Method of Payment: ❑ Cash ❑ Check ❑ Mastercard ❑ VISA Bankcard#: Expires: VIN#: Authorized Signature: Work completed satisfactorily Date (INSPECTOR) PLEASE FAX TO CITY OF SPOKANE VALLEY UPON COMPLETION (509)688-0037 REVISED 1W25/05 * - C.) --I -.I SPRINGREL z , o z NE ' CT Progress ,' --• '' . cc U.1 Earn cz cc ALMM z 0 0 I-- , ..... 2 = Cf 'CC . , c< ' 0' CC -;,; Cl) < gi ..<- . 0 0 Z 0 .>- --t 0 ..„. ..., ;--.• 0 (f) WAY cr 2 co = VALLEY WAY oi ›- o IIXDN cr c.0 cc NIXON CT co tu • CC 4:C Z = k AN >, MAIN C5 • C-/ "I co:z MAIN wrownIAISIA. 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Page 1 of 1 • Jodi Main From: Alysa Wiyrick Sent: Tuesday, June 05, 2007 12:58 PM To: Jodi Main; Scott Wallace Subject: 07002082 Todd Folsom 6th Ave Resubmittal of Traffic Control Plan Required Jodi, I phoned Mr. Folsom and instructed him to resubmit a revised traffic control plan. I told him he could resubmit to you or me. I am out of the office tomorrow so if resubmits to you, please email it to me. Thanks, Alysa Wiyrick Assistant Development Engineer City of Spokane Valley 11707 E. Sprague Ave Ste. 106 Spokane Valley, WA 99206 (509)688-0228 (509)921-1008 Fax awiyrick©spokanevalley.org (Contents of this email and any reply are subject to public disclosure. ) From: Jodi Main Sent: Monday, June 04, 2007 2:31 PM To: Alysa Wiyrick; Scott Wallace Subject: Thanks :) Jodi Main Commercial Permit Specialist City of Spokane Valley Permit Center 11705 E Sprague, Ste 8-3 Phone: 509-688-0203 Fax: 509-688-0037 6/5/2007