22006 98TH AVE W.PDFIII . 1111111111
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22006 98TH AVE W
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PUBLIC WORKS - ENGINEERING
ACTION REPORT
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STRI:t IftiLt
SUSPENSE DATE:
Date:_ Time:
JA0 jn File#
SUBJECT: �0 I Attachments:
-Q-
REQUESTOR: NAME: ) I
ADDRESS:
PHONE:
REQUEST RECEIVED BY:
TELEPHONE
CONTACT IN OFFICE' r--j
OTHER:— r---i
RECEIVED BY:
ROUTE TO:
ACTION:
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2640
C=Yes
C:::]No
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All concerned Notified
Ac ls�-]
COmpleted/File
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A
APPLICATION
for
The City of Edmonds SEDE SEWER PERMT
EASEMENT No . ..........................................
NEW CONSTRUCTION E] REPAIRS E]
40 -04000
OWNER----------- I.-H.-Elm-ell ------------------------------------------------------------------- CONTRACTOR ................................................................................. ---------------- PERMIT No . ......................
ADDRESS ....... g2.0.06 .... 98t.h --- Amenue .... W ................................................ LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No. . ...........................................
.. .. .... ....... .. .. .... .. .... -
0
0
NAME OF ADDITION
Dye Tested On Sewer 1972
Approved:
DATE................................................ By ......................................................................
1 0
Z
_� ID
N TO
SCALE
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Notes:
- 1. All signs and -so . acing shall conform
to the MUTCD and City of Edmonds specs
2. Alert affected residents
3. Channelizing devices are 28"
traffic cones.
4. Maintain a 13'driving lane on
pavement for /b vehicles.
5. All signs are 48" x 48" B/O
unless otherwise specified.
6. Work zone is 10' e/o c/I 98 AVE W
& 11 6's/o c/I 220 ST SW
-0— -No-
- — — — — — — — — — — — — — — —
220 ST SW
Pilchuck Contractors,. Inc.
Job #109016664
5 Nov 03 -
Sheet 1 / 1
J. Buss
National Barricade Co
CD
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21'
VV r_ 11" 114
PAVING
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ROAD
WORK
_41W20-1
AHEAD
CHANNELIZING DEVICE SPACING (FEET)
TAPER TANGENT
'20 20
LEGEND
WORK AREA
28" TRAFFIC CONE
--0- EXISTING TRAFFIC FLOW
'SZ SIGN LOCATION
PROTECTIVE VEHICLE
ORWORKVEHICLE
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ucK uon'tracliors inc *jAIJ / Pernt / Work Order Reauest
Foreman Name:
Address:,-
�2,200 6., 9 9 100,0
zip Co e.
"Vo..r -7,
SAP#.
Leak# ---
Plat: 1(0,-5 0
Thomas -Guide:
Locate #
No Parks Required? Yes -
Permit Required? No
City/Cnty? j=dw
Flaggers Needed? LAZ-TYes-]
How man ?
Job Start Notification? IMUM-071-7d-
Traffic Plan?
Hoe?
2-Man?
Surface Tyr)e:.
Hole Size: :a--"x
Instali: pe-
223
Size/type/length:
Retire: --=14 S-r-do
Size/typetiength.-
E-1
Check One
Service Leak Repair -
ISTW Main Repair
Cl Main Repair
Bare Stl Repair
IValve Repair
]Service Valve Repair (HOS)
Date:
Scattered Service Replacement Residential
Scattered Service Replacement Commeirch-il.
Cut & Cap.
Short Main Rehabilitation Res (Few Feet)
Short Main Rehabilitation Corn (Few F'eeQ
SAP# For Main Replacement (One Block)
Specific SAP# For Maintenance (Main or Service)
CP Work order
.QuickNotes by Clouffight Stationery—Greenweave Page I of 1
McConnell, Jeanie
From: Sidick, Susan R -Pilchuck [susan.sidick@pse.com]
Sent: Wednesday, March 17, 2004 3:27 PM
To: Mcconnell@ci.edmonds.wa.us
Hi Jeanie,
I faxed over on the 3rd of March two applications for extension's of
two months on these permits # 2003-0323- 22006 98 AVE W,
and permit # 2003-0311-- 220 ST SW & 92 "E W. I still haven't heard
back on these two can you tell me if they have granted the extension
or is there anything else I need to do on these permit's?
Thanks for your help.
-ZA ( C
WoM RVW 5*1-6�
3/17/2004
ce
City of Edmonds Permit Noc::?,& 0, 3 03Z?
RIGHT-OF-WAY CONSTRUCTION PERMIT Issue Date: 0-3
(j
A. Address or Vic . iffity of Constfuc.tion: R 00 9 R au,
B. Type of Work (be specifit): &,)r U I C (t, A
q & Cku-e-, tj,) A , I I ca, -;, 0 � , 0, 1 C_ S, LV
421 q
C. Contractor: 0, a) Contact: ls� La
Mailing Address..\ ��,of, lu(z aLJ Phone: �zgo(, - 9
StateLicenseg: P(Le�tr /o I I'vi V; Liability Insurance: Bond:
D. Building Permit (if applicable): Side Sewer Permit # (if a'p'Plid`abl6)-.-
V
E. Su ft
jE1 bdivision,"' f-E];;;C j ; ' i EUC (PUD, VERIZON, PSE, AT& T, OVWD)
y Pi;-o�bct 'El
th-
Multi-Family E2Sing'le Fi4mily D ') / '_
er
INSPECTOR:'
F. PAVEMENT CUT: NO )00 SIZE OF CUT C), x -.q
— . - . —,CONCRETE CUT: El YES El NO
INDEMNITY. unde*rstands his/her si ature �to'this applicati h e the Ci� of Edmonds harmle' ftom
qV elsh h6lds ss
injuriei, damagespr 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 but not limited to the defense of any legal proceedings including defense
costs and attorneyfees by reason ofgranting this permit.
Tli& CONTRA CTO)i IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK. "ESTIMATED RESTORATION FEES HILL BE HELD UNTIL THE FINAL STREET PATCH IS
COMPLETED BY CITY FORCES, A T 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 stieet-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.
CA�LL DIAL -A -DIG (1-800-424-5555)PkiOk` T`6 -BEGINNING WORK
I HAVE READ. 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
Signature: 'kJ�Q Date:
(Contractor 9.Agent)
FOR CITY US 0 -KuW O(VIWJ 5(2Aj6A-'
4 <W NLNL
S1 UA
Approvedby: jAjA4F PAVAjkr/N% ig t-of-way Fee: 0
Time Authorized: Void Afte�' i Disruption Fee/Fund 111:
Special Conditions: AA.k N' rA A-K, A JU I N I A4 i.; m SFT- Restoration Fee�
6—A (x FAO A4 r i ry n ii S00-to 6 S (IT)LI Total Fee: Z 7S, 0
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01, eceiptNo-
a, 0 C A J-61 10 bf) N 0 f r:.0j20PS-jDF-s ri.2i'A NS I t4 rOlssued
WA-1 nF*- rP.AFFt#1..' Aiv_4AA4-!,0Lt 40F_� .2" F".Crvxe a Sy
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UPON COMPLEYfON 0 PERMITTED WORK, AN ENGINEERING FINAL
INSPECTION �."EQUIRED PER CHAPTER 18.00 OF THE EDMONDS
COMMUNITYDEVELOPMENTCODE (Phone 425-771-0220, Ext. 1326)
FINAL APPROVAL OAQP.ERHITTkD WORK.' DATE:
Inspector's Signatv�e
For inspection requirements see Engineering Inspection Information handout.
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DAMy Documents\Forms\Engnrng\ROWpermit—.doc