2013, 04-30 Permit App EGR-2013-0012 Sewer, Water Installationi
Spokane
`alley
4.
mmunity Development Department
mit Center
1703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 720-5240
Fax: (509) 688-0037
permitcenter@spokanevalley.org
(Staff Use Only)
PERMIT No.:
CHECKLIST?: ❑Y ❑N INIT:
LAND DISTURBANCE PERMIT APPLICATION
STAFF USE :
❑ ENGINEERED GRADING
APPLICANT USE :
SITE ADDRESS: 1803 & 1823 N. FLORA ROAD
❑ REGULAR GRADING
ASSESSORS PARCEL NO.: 45124.0147 & 45124.0153
APPLICANT NAME: LANDED GENTRY DEVELOPMENT, INC. - DAN MELVILLE
PHONE: 928-6523 EMAIL: DANIEL@LANDEDGENTRY.COM
CONTACT NAME (• SAME AS APPLICANT):
PHONE:
EMAIL:
❑ GRUBBING & CLEARING
Project #,�"�"��-�'Z
APR 3 0 2013
CSV PERM�ST CENTER
CELL:389-28
SUB # REV. #
CELL:
PROPERTY OWNER NAME: LGIE, LLC AND KDGRA, LLC: CONTACT DAN MELVILLE
❑ CHECK IF APPLICANT
MAILING ADDRESS: 504 E. FAIRHAVEN
CITY: BURLINGTON
STATE: WA zip: 98233
PHONE: EMAIL:
CELL:509-389-2865
CONTRACTOR NAME: (.TBD):
❑ CHECK IF APPLICANT
MAILING ADDRESS:
CITY:
STATE: ZIP:
PHONE:
STATE LIC. NO.:
EMAIL: CELL:
EXPIRES: UBI:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
CONSTRUCTION OF A SEWER SYSTEM AND WATER SYSTEM THAT WILL SERVE THE ENTIRE 48 LOT SUBDIVISION OF NAMED CENTENNIAL PLACE.
ESTIMATED QUANTITIES (CUBIC YD): CUT: 1000 FILL: 1000
IF CUT, PROVIDE DESTINATION OF SOIL: ONSITE
START DATE: APRIL 2013 ESTIMATED COMPLETION DATE: JULY 2013
1A7.41
Sign ture: Date
04/30/2013
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