106341537-24208 100 AVE W.pdf0 \:L L?,11(7.
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ROW PERMIT NO.: ENG
ISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: 106341537
CONTRACTOR: PSE/Infrasource
Mailing Address: 1660 Park Lane, Burlington, WA 98233
State License #: INFRASL871 C2
City Business License #: N R-023614
CONTACT: Sue Sidick
Phone #: 425-457-6353
Fax #:
Email #: Susan.Sidick@pse.com
❑ Liability Insurance ❑ Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 24208 100th AVE W
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
❑ Commercial ❑ Subdivision ❑ City Project ❑ Traffic Control (Only)
❑ Multi -Family ❑iC Single Family ❑ Other
❑ EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit?
ANY ASSOCIATED PERMITS?
❑ Yes ® No
BLD# ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific) : Work area is approx 14' N c/I of 242nd PL W
& 95' W c/1 of 100th AVE W to install gas service (1) 4x5 soft surface cut anticipated
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES ❑ NO ❑ Year: 1063
PAVEMENT CUT:
CONCRETE CUT:
❑ Yes ❑ No
❑ Yes ❑ No
If yes, indicate size of cut: 3
If yes, indicate size of cut: —
x5
x
RIGHT-OF-WAY
CLOSURE
AREA
TOTAL
DURATION
(NUMBER OF MONTHS)
Sidewalk 48 Hrs + LF
X
LF
SF
Alley 72 Hrs + LF
X
LF
SF
Parking 72 Hrs + LF
X
LF
SF
APPLICANT TO READ AND SIGN
*Traffic control and public safety shall be in accordance with City regulations as required by the City
Engineer. Every flagger must be trained as required by (WAC) 296-155-305 and must have certification
verifying completion of the required training in their possession.
*Restoration is to be in accordance with City codes and Standards. All street -cut trench work shall be
patched with asphalt or City approved material prior to the end of the workday — NO EXCEPTIONS.
Indemnity: The Applicant has signed an application which states he/she hold the City of
Edmonds harmless from injuries, damages or claims of any kind or description
whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds or
any of its departments or employees, including defense costs and attorney fees by reason
of granting this permit.
I have read the above statements and understand the permit requirements and acknowledge that I must
follow all requirements in order for the permit to be valid.
Susan-1 1 - Digiie signed ,d Suse ,1111 /LO/LO
I d I cK DN at=Susan 11 " ,=di,nitlin DepaNnUS ou=Muniapal
SIGNATURE D1b.201806��1132n=8 0700=e�nm �-Ds DATE
Deia: 2018.06 21 13:20 38-0�'00'
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Job #:
Date:
Jurisdiction:
ROW Permit:
Est. Start Date
Est. Duration:
106341537
6/15/18
EDMONDS
Yes
CYCLE C
Puget Sound Energy Gas Pre -Inspect Form
Address:
City / Zip:
Customer:
PM / Inspector:
24208 100TH AVE W
EDMONDS, 98020
TRACY TALLMAN 206-396-6650
Kevin Williams 425-691-7573
Job Description / Scope of Work
From 2" STW main run new complete 1-1/8 PE service to single family residence(11' scat stub
New Construction:
No
with 51' scat
extension) set A-250 OL @ Inches
Construction Method
All Scat / Trenchless
PLAT Map:
167.066
t
N
T
10015
A
5 MPE
250 MSA
I
24208 , 9931
I
`w l 5/5' PE
I 1986
3
1-1/8"
PE
I Ss
I
11
I
2 STWIP 14'N------------
Sewer
�7✓�4
T — — — — _ _ _
e — Sewer
T
t�
ILI'
1 1 �S a
II
I�
24222
`a
9932
18
3
1 /2 ST
1968
1 1"S 98ZE
5/g' PE
1986
Work Location
Size of Cut
Surface Type
14'
N
of CL
242nd PL SW
&
95'
W
of CL
100th AVE W
45
Soft
of CL
&
of CL
Of CL
&
of CL
Service Information
Street Information
Job Type
Diameter:
1-1/8" PE
Flaggers #:
Arterial:
New Residential Svc
EFV:
1-1/8" - 2600 - 9999144
Police #:
TCP:
Yes
PUGET
ENERGY
Meter:
A250
Speed Limit:
25
No Parks #:
6
Meter Loc:
Trolley Lines:
Mtr Hoods #:
Del Press:
6" W.C.
Traffic Signal:
Bus Stop:
Bollards:
2.5" # 4" #
ADA Ramps #:
Route #'s:
Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 008997
Card Exp. 08/13/2019
gregory.harwood@pse.com
(425)424-6425
Notes:
1. All signs and spacing to conform to the MUTCD
and City of Edmonds standards.
2. All sidewalks, driveways, exits and egresses
shall be completely clear unless otherwise indicated.
3. Channelizing devices are 28" traffic cones.
Use traffic drums (barrels) with steady burning
Type C lights on all State Routes and Hwys.
4. Sign size can be a minimum of 36" x 36" and shall
not obstruct pedestrian access.
5. Crew is required to leave a minimum of 11' for
traveling lane width.
6. Alert affected residents and businesses.
7. Work to take place between 9 a.m. and 4 p.m
unless otherwise specified. All work for arterials
and major roadways will be from 9 a.m. to 3 p.m
8. Work area will be 14' NCL of 242nd PI SW and 95 WCL
of 100th Ave W.
9. If used, place NO -PARK signs 72 hours in
advance of the day that the work is to be done.
CHANNELIZATION
DEVICE SPACING
MPH
TAPER
TANGENT
55/70
40
80
35/45
30
60
25/30
20
40
4APPUGET
SOUND
ENERGY
JOB# 106341537
24208 100th Ave W, Edmonds, WA
June 18th, 2018
patrick.byrne@pse.com
425-424-6618
Sheet 1 of 1
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FLAGGER
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FLASHING LIGHTS
SIGN LOCATION
RIGHT OF WAY
ROW ROW