307 FIR PL.PDF11111111111111
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307 FIR PL
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City. of Edmon'�
RIGHT-OF-WAY CONSTRUCTION.
PERMIT Permit Number.
Lssue Date:
A. Address or Vicinity of Construction: 307 F I R PLACE
B. Type of Work (be specific)�GTE to 121 ace, qkRerate and mai ntai n a buri ed servi ce
ISC)IJ
Mrf, from eXsiti,ng pedestal #9931, located at 1028-4th Av. S.,then south.to a residence at
1
307 FIR PLACE. GTE to plow 1781, push 1 driveway, 221, and push�no roa?ls. R.O.W. footage is.75 feet.
C. Contractor: GTE NogTHWEsT INCORPORATED Contact:Linda Price� permit coordinator
Mailing Addressi,41:1c: 1.1,r Phone: 425/710-4133
,t; GasiFie Read,gver-ett I'M
State License #: 98204-1440 Liability Insurance: Bond: $
D. Building Permit # (if applicable):
I
Side Sewer Permit # (if
ENGR: Robert Chrisman
1 or pgr# 425/787-4045
E. 0 Commercial E] Subdivision El City Project ;V Utility (PUD( "T WNG, CABLE, WATER)
EJ Mul.ti-Family )V Single Family El Other 11 �).
GTE dqR4-#,J2l00-9P00l DB QA2 i4 fb'�
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut Yes []No G. Size of Cut: x H. 4�harge $
PLEASE ME ATTACHED PR I NTS.
APPLICANT TO READ AND -SIGN.
INDEMNITY: Applicant understands and by his signature to this application to hold the City of Edmonds harmlessftom injuries, damages, or claims ofany
kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or any of its departments or
employees, including or not limited to the defense of any legal proceedings including defense costs and attorneyfees by r�ason of granting this permit.
THE CONTRA CTOR IS RESPONSIBLE'kOR WORKMA NSIIIP A ND MA TERIA LS FOR A PERIOD OF ONE YEA R FOLL 0 WING THE FINA L INSPEC-
TION AND ACCEPTANCE OF THE WORK ESTINIA TED 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
Two sets of construction drawings of proposed work required with permit application.
A 24 hour notice is required for inspection. Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept'clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations a's—required by the City Engineer.
All street cut trench work shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
I have read the abov5,&(atem d1nderstand the permit requirements and the pink copy of the permit willbe
available on site at efM times 7or 7iMe ion nurnases.
Signature:
Date.. 7-29-98
(contrayror or Agent)
David Squi t i W
wAcess Desiqn
-DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
'_*7 ^ 0
APPROVED BY: RIGHT OF WAY FEE: _;� 2(.) '0-
TIME AUTHORIZED: VOID AFTER I-L) DAYS DISRUPTION FEEIFUND I I]:
SPECIAL CONDITIONS: N14 RESTORATION FEE:
T OTAL FEE: _54 k.161.0.2
RECEIPT NO.:
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Di� 1997 '\�