17102 67TH AVE W.PDFiiiiiiii lill
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17102 67TH AVE W
APPLICATION
The City of Edmonds for
L SIDE SEWER PERMIT
.a
EASEMENT No . ..........................................
NEW CONSTRUCTION REPAIRS E]
OV*rNF,R ......................................................... ..................................................... CONTRACTOR .... 4:L�-A ...... . .............. ................................... PERMIT No,* ......................
ADDRESS . ........................................................ :w_:._w._...: ........
-5�7-7 ........... ........ LEG -DESCRIPTION: -LOT No.: ..... ....... * .............. * ............ :"BLOCK No . ......................... ..................
NAMEOF ADDITION-: ........................................................................................................................................
cer
EX%S,Tr.
I'�,.'Ifoc'�'-,��4OVIf-3PANTYOFACCURAG( The InformtHion sho,,.-r, on
atlach�d map wx2 compiled for use by fl e City of Ed:nc—f's; i"--
an- conswiltants The City of Edmonds joes not warrafill E-�l
any�n!;;o set forth or, the map. Any p(rson or entity rcq
gara,
s t " c �1 C 0; i d - 4--- t an i n d a p,,; o �i P, i- i i I n q u iry �6 ng Me inic-
th rnap, Indud4ing, but noi limited to, the locaiion of an�
stfov!o- . Sur.'�-' sta.13 may or may not e)dst and may ar r,zy c",
W, locahoo si'c'mi, Neither the City of Edmonds nci its
c.':. f-, the- information givein op'this map, rr-;
said
Approved:
D A ITME 77 7/_! ..... By ... ... . ... .. ............ ; . ...........
"NOND
CITY.U.0FA DIM S, 6,E'
El S41, SMERIPE, M
:MAT -DEPARTMENT''�
Ek9EW,*lV,
I a
"%T
+4
-,'PER. 1, 1'
11 . r F LE IMT T
4`4671 -fov*,.ide,':sewer� ins ectionst,BEI� I ORV coverlhg iny,' portion . "of' the �copstructjcn-.,y, -
�rnspectj6
n�willFbel�provided�-within,'2',I !hours, after request. NOl,Sai.,!S n onhbliday, Inspections./;
.17102:' 6 7th - -AV
enue. west
DRESSM-Q.'PlATTON; OF'fOONSTRUC
................
.................................. ................................................... ...................
MrERTY�XEGANL ilDES , RIF ............. 0. Mal Ranch-, Lot, I I
_Q T.-I 0 m'". .' ......
-D ......... .....
........... ...... 1,
........................... ....... 7:7. .........
. ........... ...........
........... ........
7 .... . .. . ... ............................................. . .. ... . . . . . . . . .... . . . ... . . . . ... . ... .... . . .................................. .................. .............................
.......... Ll,oyd.:Anc ersom
........................ . ........ _ON, "WER, AINDVOR', BUILDER
......................
.................................... ........... .............. ...............
-Bob Ch6mbe.rs-.: C :ud .oil, -6 o-h & W "a
IC6R�PWA'b- TbR;S��T� Edl&.,"DRES§�... . ons.tr tj
...................................................
. . ............ . ... .................................... . . ..
..........
Septe
.......... f6'r%repair- '�Wor�. or
....... ...... doniiieetl 1 dfAosid&isewer, ��San ar-y/ (sewer-,
system-iii�'aee; o-rd'hri, 'Ith,
cei�w �tC,!tk/;df,�,,�dmond��t.or4fiiances�.,
1�k� TIOM ISVCANLL'ED�TO�TH
E;'7�0LLOWINM,
Nix,i�o� 1'—The,owners�iof',the),Prope'rty-'��y/��.�t.a,iL'� I�.
rmit"ito,:coristruct 'A-ilcerise.& SideSewer fContractor�,muit -be�.6rriolby,edL'�'to',�con�truct
nbt,cover�,any. 'Port Iow,of.`6ewubeforeA t ihasPbeem 16 specte&
POTE;,.No.-�2—'AlIlr,work �Perf6rmed!-Jw -city! right 26f-way . requires"am invasi
onl;of RJght-of-Wa.y'PermIV.obtaIn&bIe
from-fthe�tCjty,,Englneer's office.
F�OTE,;'�Noi,,�3—'ObtELih,'full��ffiformaitoniLregal-�i�"i,b-rdin�n,�e l�li.-I6.,030,�,andl�Reg�la'tio'nsl.!goveini�g,-,s�d�;�se�verB�,�vhent��,o�i ' :g et"permi
NOTE:,No: 4—T(;P-�iof�'��idevs�w6r,'must,lha,�,�, ait'l'east Minches.,'6 * e'�a e'at �properiy? -line,, and!'.12,, inch'es�,Ilnk'�e- pr_��6ty'qllne �mjnjmujn..;g
;sha:rpev th V rad*e�.of,"2't7o.,'��i4i))tben�6:�',�ini�grad6,,,
NO,T-Ei'No�,,5:--lT-i6nches �ini:kFeet,muit�)be),,,,�ii*afet�,settl'edi4andkisurfi�c�l,of� stieet, restore �fw originail, condit-lo; . 1�
.0 %resp6ifsibl�!��or,.f*iLiluie�idueii6,�lirripro�erl"�
�wprkt,whichi iray-,develitpi wIthlw%'Oriitt; k.eail of completl n.'
0
NOTIDPNo�.�&---Jt �isi,unl�wfullito,�alter,,or,,idol,&ny,*�other,:work,thiLn�,is-.proyidedl:�or�-in jhie! permit;, or�:t&iddTiank,,Woik,�orvtthet:main.-sewer'L� )'exc6
:Bert�i�he,,Pipe-�into,�the,,wye.,. orl s. appurtenances 1 p to)
IL ............
a e ......... . .
ISAPPROAVED) UE�te� ... M; ............
.........
...... Ay.
....................................... ...... .....
R6inar
* .. .........
.................. ....... ........... ...........................
....................................................... ....................................................
................ .......... ..............................
7 . . . . . . . . . . . . . 7 . . . . . V . . . . . . . . . . . . . . . . . .
................. ....................... ........ .. ............
BOT�, Pdeni�x 16SI, j i me -B
1,of Fiii�i� 41,iarf'orlilfr!g,�,Construct-ib'n'' R
...,FR�OWToi� ,e -,F -ibnl
quest on'Insped
%
-;,�,herebYL'certUyt rue a Tf r ithiWipernift,
, I j , -hatthe)tsffle ewwer�lnstallatiomconst t du de'
AD
P
P.
e,
. . .............
:(6 .Of"Cont�ract ng. M, n onstruc lon)"
V, 'St ed) 4nt - aceord_aMe) w,it-hifall�g�,verning,,,(ordinai ce&:oCA-fie, �CjtYr*�Of!-Edmon'ds,.,':'
IDatedl tblsi;.% ...... tday-4f ...........
7.7
...... .. oa
I it
V,'� ��!,C heck,'BEFOREI .,.'.`TekPhofiei:Ol,'- 'Tower,lUl,'. S'e"W. e b '6v 1
�Gas
T69 City of Edmonds
APPLICATION
for
SIDE SEWER PERMT
NEW CONSTRUCTI3Z;B"— REPAIRS EASEMENT No . ..........................................
ytL
A
..........................................
ADDRESS /V.02 ..........
_0
E
e '*.*
0
CONTRACTOR ............ PERMIT No. 4k� ......
LEGAL DESCRIPTION: LOT No. ............................. BLOCK No . ............................................
NAME OF ADDITION ..... Z:: . ..................................
13V
'IMACY T-r ci th
'r The Iniorm
. 7
Ai,
In —
of,';. u,4 nc, fL, U7'
1, , lCis.e. - uL, oruvt:U-6,.4ti��;.LJUPU,iSaiLiM4,j
1171
Ale
Approved:
DATE................................................ By ......................................................................
Date: . September 18, 2000
To: Verizon — 172nd & OVD
From: Maryanne Zukowski Traffic Engineer
Subject: Right of Way Permit traffic control conditions of approval
Traffic Control in the City Right-of-Wa
All signs, barricades and related equipment and their use must be in accordance with
Part IV, "Traffic Controls for Highway Construction and Maintenance Operations," of
the Manual on Uniform Traffic Control Devices, as prepared by the National Joint
Committee on Uniform Traffic Control Devices and per the City of Edmonds
Developmental Standards. Reasonable accommodations shall be made for distance
requirements in signage for geometrical conflicts.
Coordination with the City Inspector prior to all work. Particular attention should be
made to the following items:
There shall be at all times reasonable pedestrian and vehicular access to and
egress from the properties adjacent to the project, so far as possible. Contact the
affected homeowners/business owners directly to prevent conflicts. The
Public Safety Department (police and fire), 771-0200 and 771-0215,
Edmonds Public Works Department 771-0235, and the Edmonds School
District Transportation Department shall be notified 24 hours prior to
construction. Proper provisions shall be made for public convenience, safety
and travel.
Any asphalt concrete pavements, crushed surfacing, gravel base or water
required for maintaining traffic during the life of the project shall be placed by
the contractor immediately upon request by the engineer and/or inspector.
All unattended excavations shall be properly barricaded so as to prevent
accidents.
Construction along or across the City right-of-way shall be as per the contract
documents, City of Edmonds Standards, or as directed by the engineer and/or
inspector.
All traffic control is to be inspected by the City prior to construction activities.
City of Edmonds
PermitNo:
City of Edmonds'
RIGHT-OF-WAY CONSTRUCTION PERMIT Issue Date:
A. Address or Vicinity of
B. Type of Work (be specific): Ve riz on to, replace multiple old aerial cables with one aerial cable o.n
172nd St. S.W. from 013mpic View Dr to 68th Ave W. Also on'66th V1,W. and 67th Ave W..
Please see attached print.
—710-4121
Engr: Linda Granfors 425
C. Contractor: VERIZON
MailingAddress: 2312—C W. Casino Rd
State License
Contact: SHERRY JONES—PERMIT COORDINATOR
Phone: 425-710-4133
Liability Insurance: Bond:
. D. Building Permit # (if applicable Side Sewer Permit (if applicfile�-. 1,
E. -Commercial F] Subdivision E] City Project EUC.(PUD, CHAMBERS, OVWD)'
Multi -Family Single Family F1 Other
Verizon WO #285 1GR294
2421.10
INSPt&OR- MPH
F. PAVEMENT: E] YES ZNO G. SIZE OF CUT x H. Char . ge: $
CONCRE E CUT: []�1,XX& NO
APPLICANT TO READ AND SIGN
IDEMNITY. Applicant understands by his1hprsignatfi-r-eto this application helshe holds the City of Edmonds harmless from injuries,
damages or claims of any kind or do��.:�i�'Zion' whatsoever, foreseen or unforeseen, that may be made against'ihe City of Edmonds or
T,
any of its departments or employees, including but not limited to the defense of any legal proceedings including defense costs and
attorneyfees by reason ofgranting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES, WILL BE HELD UNTIL THE -FINAL STREET PATCH IS
COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
+ 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. All street -cut trench work shall be patched with asphalt or City -
approved material prior to the end of the workday — NO EXCEPTIONS.
# Three sets of construction drawings of proposed work are'required with the permit application.
IRAVEREAD THE ABOVE STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE
THAT I MUST MAKE THE PINK COPY OF THE PERMITA VAILABLE ON SITE A TALL TIMES FOR INSPECTIONS
z) - 00
(Contractor or Agent)
CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK
.1. * 11 1 1 FOR CITY USE ONLY
Approved by: Right-of-way Fee 11VIA�
Time Authorilgo void-1fter 11 /' 1-1, 00 Disruption Fee/Fund 111:
SpecialCon tions:10f 4ffi'r. Restoration Fee:
2- 1�) 4t�
(MAlt'!(1A i , Nho 041n]—r Total Fee:
Receipt N'O- 41-)
Issued y:,
UPON COMPLETION OF. PERMITTED WORK, AN ENGINEERING FINAL
'INSPECTION 1S REiQUIRED PER CHAPTER 18.00 OF THE EDMONDS
COMMUNITY DEVELOPMENT CODE.
FINAL APPROVAL OFPERMITTED WORK,
INSPECfOA'S SIGNATURE DATE:
For inspection requirements gee Engineering Information Handout.
I NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE 3
15:501
DAH:1076
T-371
EML 5.98 dB ELR 1424.4 fl
END SECTION
MAX BRIDGE TAP 01
AML ALR
OFFICE LOOP LIMIT 1500
APPROVED BY DATE
WRECKING
CABLE TYPE
MOT.CODE
FOOTAGE
YR.PL.
AE25-22
221425
200'
1968
AEI-22
221280
474'
1973
SS26-22
212226
674'
1960
SS2G-22
383'
1968
DW6-22
2152OG
176'
1963
4),
"o,
#8540 188+34
318 7 r�71
ZP2SI L�F_
DAH.1051-1075
AE25-24-
4no�
.9
DAH:1026-1050
F-1329 AEF25-24
DAH.1026-1050
UG—AEF25-24-0—G
e A
0 Ge
UG
�certify that work I completed on this work order and As -Built
s In compliance with GTE Quality standards as Identified on the
IPOIP checklist.
(Signature and Date)
nr &
I
21 13
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DATE
9-5
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22
20
42
W61
U5
FA
AH:1001-1025
AH:1026-1050
AH:1051-1075
AH:1076-1100
AH XCONN LOCATION: OLYMPIC VIEW DR & 170TH PL SW
FCA COUNT TO ADDED TO XCONN AH ON W.0.2850-9PO01GR-267
NOTE:
PLEASE NOTE:
STENCIL Co PLEASE
M
Lo
TER 00 00 STENCIL
CO #
TERM
Q)
P2S6
3 Lq 400
P2S4
399
4?
�300
P2S2
3 C�8
NOTES:
FACILITIES
PLEASE CORRECT AAIS RECORDS
ADD T-2912 TO AAIS
ADDRESS IS 17015 67TH AV W
WKRS ARE AT: 17015 67TH AV W
6628 170TH PL SW
EXISTING RECORDS SHOW THE
ABOVE ADDRESSES WORKING OUT
OF T-2827
LU
ICGS
P 2
222 PLEASECORRECT -STREET-NAMES-
& NUMBERS AS SHOWN ON PRINT
X NOTE:
STENCIL NEW TERM 2837 NOT
2831. OLD ONE STENCILED WRONG
TKI AATcz rnpprrT
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AKF25-24 (�ro
250,1 LAP_
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220 172ND ST* SW 219
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DAH:776-800+
1026-1100
AKFI-24
325' LAP
250' LAP_ 62+64 U5 P14
L 8444 217
LE51
2585
A Ic DAH:1001-1025-25XD
A X,C -V
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218 AE50-24 21
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TO C.O.
IN SERVICE DATE 11-06-00
PERMITS
CONSTRUCTION
El BLANKET
El STATE
El DIAL. A DIG
[I COUNTY
X C I T Y EM40NDS
X FLAGGING
D BRUSHING
D NONE
SPECIAL CIRCUITS [I
CAUTION
POWER NUG XAE
CUTS REQUIRED
YES 11 NO
OTHER X UG )( AE
TELCO XUG XAE
JOINT POLE
El PUD
JOINT TRENCH
El PSE
EIPUD
El CATV
F1 PSE
El GTE
1:1 CATV
X NONE
El GTE
FEES RED'S
POINT OF CONTACT
El GOP El LEC
0 SPEC. CONST.
)0 NONE
ENGINEER LINDA GRANFORS
PHONE NO. 425/710-4121
FAC TECH STACEY BRAGER
PHONE No. 425/710-4129
FIELDED BY BOB FOSTER
MATERIAL
MATERIAL
ENGR
CONST
CODE
DESCRIPTION
EST
ACT
280425
AKF25-24
2501
280450
AKF50-24
750'
280480
AKFI-24
325'
280482
AKF2-24
250"
529200
IOAI-2-24
I
25'STUB
DAH:1001-1100+
100DD
—10AI-2-24
25" STUB
G33sm
EXCH
MANORA!��
COUNTY
SNOHOMISH
TITLE: AH CONGESTION
172ND ST SW FM 68TH TO
OLYMPIC VIEW OR
x
N
RELIEVE CONGESTION &
Srl
REPLACE OLD SS CABLE
M
APPROVED BY DATE —Z
C
x
CD
M
T-27N R. 4E SEC. 8A
SHEET I
I NO.: OF I
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0