311 9TH AVE N.PDFiiiiiiiiiiiiii
14819
311 9TH AVE N
890
C. Contractor:
City'a Edmonds,
ONSTRUCTION
RIGHT -OF -WA,' C
Wue Date:
TERMIT Permit Number. 9- .12 >
A. Address or Vicinity of Construction: 9 311 9th Av N
. - GTE to place, operate, and maintain a buried service
o 9 D. lype OL VVU11L k00 SpeC111C): Wi rA frnM pxqt'ngAPn_'8 "I'liq Inc-ted -t 9th Av N &
Edmonds then west to a residence at 311 9th v N. GTE to plow 55 feet pushing
no driveways and no roads- R-0-hf- -5 fGat
Mary A Bower, Permit Coord. Contact:
CTF NnrthwAAt IncocPorated F)p-nnis Alexand,-r 771-9()'Ar, nr rnn�ilf- IRR-11c;
Mailing Address: 2312C W Casino Rd Phone:
Eve.-att, WA 98264 14% Mai� 266A68 i626 or 3110 4139
State License #: Liability Insurance: Bond: $
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. 0 commercial EJ Subdivision El City Project R Utility (PUD, (�DWNG, CABLE, WATER)
0 Multi -Family EJ Single Family [] Other 2100-9POOlDB 242310
INSPECTOR: INSPECTOR: 4 c,,t
F. Pavement or Concrete*Cut L1 Yes U]No G. Size of Cut: x H. Chargq�_$
Please see attached ske I :h.
APPLICANT TO READ IGN ?i.�?, damages, or
INDEMNITY.- Applicant understands and by his signature to this application, agrees to hold the City ofEdmonds harmless from i
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 or not limited to the defense ofany legalproceedings including defense costs, and attorney fees by reason ofgranting thispermit.
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 TIMEA DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
Construction drawing 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 as required by the City Engineer.
All street cut ditches shall be patcl�6'd with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
Ihave read the above statements and understand thepermit requirements and thepink copy of thepermit will be
available on site a
,ne �insption purposes.
Signature: John H. Stewart Date: SnptemhAr S. lqc)r,
(Contractor or Agent) oprns Supv-OSP Engrg.
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVEDBY:
TIME AUTHORIZED- VOID AFTER DAYS
SPECIAL CONDITIONS: MW JDQ' NIM
I &) JAJAY (-)I= r-makMALMeL
_AS o" NT Im 0 :j A 1,49/6 if A VE PAIJ I tO
COMMENTS:
,C(:> w -CA C_-T _N A S 0,%J S� 4 A yt-
DATE:
RIGHT OF WAY DEPOSIT.
DISRUPTION FEE/FUND,111--.
RESTORATION FEE:
PERMITYEE:
TOTAL, FEE: ap, 00
RECEIPT FEE:
ISSUEDAY:
�A
NO WORK SHALL BEGIN PRIOR TO PERMITISSUANCE Engrg. Div. 1991
FIELD INSPECTION NOTES
Comments:
I Diagram.:
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION El YES El NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:. -
FINAL APPROVAL BY: Date:
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PERMIT SUBMITTED BY
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- - - - - - - - - - - - - - - - - - - - - - - - - - -
LEGEND
PEDS 0
POLES 0
ROAD BDRES
OVERHEAD LINES- -
1AILITILITY POTHOLE 1=3
UG TRENCHING ---4JGT-
R.O.W.
* ----------------------------- EOP
�FTH AUE NJ N Au b
-----------------------------------
A16.56., CZ=>-.ze— —§p___1-_X_�1.ST1A)G FLOLUFk PDT I lu SI'Df- WnLK
rL A Of' / 5 FR LLS LJ
THE FOLLOWING INFO TO BE PROVIDED
RIGHT OF WAY LINES.EOP OR FACE OF CURB, EXISTING SIDEWALK, POLES, ROAD CUTS AND THE UTILITY UNDER ROAD C'
ABOVE. .-GROUND FACILITIES.fle-.) PEDS,BOXES.,CABINETS, ETC.,UNDERGROUND TRENCHING ANO OVERHEAD LINES.
FOOTAGE OF WORK IN R.O.W.
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0
In
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PERMIT SUBMITTED BY
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r*ri
or
- - - - - - - - - - - - - - - - - - - - - - - - - - -
LEGEND
PEDS 0
POLES 0
ROAD BDRIES
OVERHEAD LINES—
[AUTILITY POTHOLE =1
UG TRENCHING --UGT-
- - - - - - - - - - - - - - - - - - - - - - - - - - - -
5FTH AUE NJ N Au b
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I A16.56., c2n�,� , e f--X_S/Sr/A)G FLOLUFk PDI- JlU S7,0f URLK
R.O.W.
EOP
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we
THE FOLLOW$NG INFO TO BE PROVIDED
RIGHT OF WAY LINES.EOP OR FACE OF CURB, EXISTING SIDEWALK, POLES. ROAD CUTS AND THE UTILITY UNDER ROAD C
ABOVE'"GROUND FACILITfES,(Ie.-) PEDS.BOXES.CABINETS, ETC.,UNDERCROUND TRENCHING AND OVERHEAD LINES.
FOOTACE OF WORK IN R.O.W.
TO
FOR. 41 - LITTLE'S
INTER -OFFICE COMM!"41CATIONS
STREET FILE DATE
FROM
19
SUBJECT:.
9
,IVRT_e Ppopep
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IF-0 p e rz, -ri DVV"C-'�_ WILL CRLL- T7-
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44
CITY OF EDM9NDS E L- L— I I I L- Lm
COMMUNITY SERVICES DEPARTMENT
RIGHT-OF-WAY CONSTRUCTION PERMIT
A. *Owner: Washington Natural Gas Co
Name
805 156 AV NE
Mailing Address
Belleyne, WA 98007
City State Zip
Address or Vicinity of
Type of Work to be E
Enstaix, 8
,77 -,-, 7,—,,f
�, / , � 40. f,
Permit No. ;?&- -1-Ar / .
Issue Date / OR - 62 1 - �� 69
B. 0 Contractor: Same
Name
Mailing Address
City State Zip
447-0700
/V� State License Number Telephone Number
Work in Connection With: El Sub or Plat El Single Family 0 City Projects
0 Commercial El Multifamily 1,3r, Utility
Pavement Cut: 0 Y El N
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City o * f Edmonds
harmless from any injuries, damages, or claims of any kind or description whatsoever, forseen or unforseen, 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, court costs, and attorney fees by reason of granting this permit.
THK,q_Q_ _1&
N R ACTOR 1S RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE
YEAR FOLLOWI NG PTANCE- THE:7W0RK:`----------
Funds held from the'Security Deposit (estimated restoration fee) will be held until the final street patch is completed
by City forces, at which time a de'ljit or credit will,�be processed for issuance to the applicant.
• A 24 hour notice is required for,inspection; Please call Public Works: 771-3202
• Work is to be inspected during progress and at completion.
• Restoration to be in accordance with City Code.
• Street to be kept clean at all times.
• Traffic Control to be in accordance with City regulations.
• All street -cut ditches must be patched with asphalt'or' City approved 'material prior to end of working day;
no exceptions.
I understand the above and that this permit must be available at the job site for inspection purposes at all times.
7;%q
Signature: Date: 12/19/88
/ Owner or Contractor
This Permit Must Be Posted at the Job Site For Inspection Purposes
Call DIAL -DIG Prior To Beginning Work
ISSUED BY:
Time Authorized: Void after —days.
Special Conditions:
Amendments:
PERMIT FEE: 0—
Security Deposit:
Receipt No.:
Fund I I I Fee:
Street Cut Dimensions:
X — =
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. July 1985' "
FIELD INSPECTION- NOTES (Fund I I I - Route copy to -Street Dept.)
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION El YES 0 NO
Partial Work Inspection by P. W.:
Work Disapproved By:. Date:
FINAL APPROVAL BY: Date:
Eng. Div. July IS