100030332 permit app.pdfz&E.—! °q 0
-ROW PERMIT NO.: ENG
G 0 ISSUE DATE:
RIGHT-OF-WAY C6 TRUCT101
PERMIT APPLICATION
4 ACT:PROJECTNAME: 60-k"MW
kA At
CONTRACTOR: Fhone*
*Lk-Z,'&- (0 0 - 2,Z I (o
Mailing Address: ?0 Fax
f-V •W Email#*
.
City Business License
Liability Insurance F] Bonded
ADDRESS OR. INTERSECTION OF CONSTRUCTION: -1 C\
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
H Commercial ❑ Subdivision U City Project D4 Traffic Control (Only)
❑ Multi -Family
E] Single Family
El EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is.this permit part of a blanket permit?
0 Other
El Yes' N No
ANY ASSOCIATED PERMIT BLI)ff ENGV
DESCRIPTION OF PROPOSED WORK. (Be Specific): S-a C.
QA:)^ STK QQ C_V� by-\ C�_ - ems-
A,
eAi�, ok
CJJ�A,
W
WAS STREET OVERLA)�ED WITHIN THE LAST FIVE �(5) YEARS?, YES-.[:] 'NO..[:] Y_Wn �-
PAVEMENT CUT: OYes- VNo If Yes, indicate size" of cut:.
CONCRETE CUT: F] Yes No If yes, indicate size of eu . t:
RIGHT-OF-WAY. DURATION
CLOSUREE�' TOTAL (NUMBER OF MONTHS)
Sidewalk 48 Hrs + LF X LF SF
Alley :72:Hrs + LF
kiX LF SF
Parng 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 fer the permit to be valid.
SIGNATURE DATE
Co. c or or Agent
NO WORK SHALL MGIN PRIOR TO PERMIT ISSUANCE
ROAD ��
ONSTRUCTION '�`
AHEAD
(_ �) SEE NOTE 1
ROAD
NARROWS `ice
30 SEE NOTE I
TAPER LENGTH o
(TABLE A)
WORK AREA
a °
TABLE A
SPEETi
(MPH)
TAPER LENGTH
(FT)
CONE SPACING
ALONG TAPER
(FT)
OFFSET WI➢TH
10'
( 12'
25
100
120
25
30
150
180
30
35
200
240
35
40
270
320
40
45
450
1 540
45
NOTE:
Ill
MIN
0
V J
1. DISTANCE BETWEEN SIGNS SHALL
BE 100' FOR RESIDENTIAL
STREETS (25 MPH), AND
200' FOR ARTERIAL ROADWAYS
2. FLASHING BEACON SHALL BE
INSTALLED AT EACH SIGN FOR
NIGHT-TIME USE.
n
CJ
3. DISTANCES MAY VARY AS APPROVED
BY THE ENGINEER.
4. FLAGGERS REQUIRED TO CONTROL
TRAFFIC WHENEVER THE CONTRACTOR
MUST INTERRUPT TRAFFIC FLOW
TO ACCESS THE WORK SITE WITH
MATERIALS OR EQUIPMENT.
LEGEND:
D CONE OR CHANNELIZING DEVICE
(SEE STD 7-14)
y
TRUCK WITH
FLASHING OR WITH
BEACON
<S"?o
TAPER LENGTH
(TABLE A)
SEE NOTE 1
SEE NOTE 1
TRAFFIC CONTROL PLAN 3-1-95 7-2
2 LANE ROADWAY: PARTIAL LANE CLOSURE date number
CITY OF LYNNWOOD - PUBLIC WORKS DEPARTMENT
PUBLIC UTILITY DISTRICT NOA OF SNOHOMISH COUNTY
LOCATION % 0� 1 q 2 C)3 _ !�_A_ lz_sw c � L� Il�tn AREA
POLE NO. 9463 NEI/4S 19 T 27 R 04 DATE 7/17/18 ORDER 100030332
REASON FOR WORK INSTL UG SEC PED FOR ENGINEER MCALLISTER OPERATION 60
7919 203RD ST SW DRAFTER U.G. NO.
1.'3KIN I n SCALE
DATE WORK COMPLETED
FOREMAN
FEES REQ'D ■ YES
PRIMARY OVERHEAD
❑ RESIDENTIAL
❑ COMMERCIAL
LEO NO.
La '=$
SECONDARY OVERHEAD
APPROVED
& DATE PRINTED
ENG AS -BUILT VERIFICATION DATE
❑ PHASING, TAPS & FUSING
❑ POLE & VAULT STENCILS SUBSTATION PRV
❑ NO ❑ CABLE TAGS CIRCUIT NO. 126 PHASE 3
❑ FRAMING
Cl EQUIPMENT LOCATION
VERIFIED BY
DATE
NESC VIOLATIONS
BASIC FEE S
❑ NO ❑ YES (SEE NOTES)
@$ '=$
PERMITS (DATE GRANTED)
❑ TREE TRIM
❑ STATE
METER/CONV. POLE S
PRIMARY UNDERGROUND
❑ RESIDENTIAL
❑ COUNTY
❑ COMMERCIAL
■ CITY
BASIC FEE S
❑
EASEMENTS
LEU NO.
.@$ 1=$
❑ REQUIRED ■ NOT REQUIRED
SECONDARY UNDERGROUND
BASIC FEE S
DATE RELEASED
La .=$
UNDERGROUND PLAT
FOREIGN CONTACTS
❑ JPN#
BASIC FEE S
ri FT.@$ '=$
❑ JOINT TRENCH FRONTIER & CATV
❑ JOINT BORE FRONTIER & CATV
STREET LIGHTING
q FT.@$ '=$
0
POLE STENCILING
WORK IN RIGHT OF WAY
FROM TO
❑ PRIMARY
TAKE OFF POLE
❑ SECONDARY
PRE-CONST. REQUIRMENTS
❑ TREE TRIM ❑ PUD LOCATOR
CL FT. @$ '=$
MISCELLANEOUS FEES
❑ BACKHOE ❑ FLAGGING
VAULT 8
❑ ONE CALL DATE
PERMIT S
Na
STREET LIGHTING
❑ YES ■ NO
s
CSLER s
S
M&R
AS -BUILT
S
GIS
TOTAL DUE S
DATE PAID
GIS QC
M&R
GIS Ph
JOINT USE
RECEIPT NO.
SERVICE ORDER NO.
LOCATION MAP PAGE 455 A-5
O EXISTING POLE
O EXISTING POLE -TO BE REMOVED
• NEW POLE
NEW POLE TO REPLACE EXISTING POLE
ENGR'S TEL. #
425-670-3216
ENGR'S CELL #
425-501-1254
AQ POLE 9463
RUN 90' OF 350 AL SEC UG TPX OUT OF EXISTING PED ATT IN CUSTOMER
INSTALLED 3" PVC AND SET NEW PED AS STAKED WA31 UG SEC CON N BARS
ON SE CORNER OF 7919 203RD ST SW ATQB
7923 1 7919
m
203RD ST-- _SW'', -
11
911 1 7909
25-29585
01
SHA10 I OF
ej)%NA%rk5 CA��Ov\
i'll"kv—
LOCA 77ON
S PRIOR TO
77FY DESIGN
EXISTS. ALL
41NED
'AS LINE PER
7ED LOCH 77ON
ELD
7 7.
5
EXISTING GROUND
CONTOUR •(Typ)
Cj DRAIN 0 07
lojMIN LENGTH 17G
T0-077NG DRAIN
DRYWELL TRENCP
(SEE DETAIL 0,1V i COVERED
SHT GN--01 '0, PA no J.
Top 171'.
-7.5' 10,
CHANNEL ORAIN
TOP 84,4
(CONNECT TO C8
WEST OF DRI bE W4 PROPOSED HOUSE
MAIN FF 85.00
PLAN il 12
DOWTURNED ELBOW
N=6620.JJ
E=5560.97
RIM 83.52
4" IE 82.08 (IN-N)
6- 1E 82.00. (OUT-S)
4- IF_ 82.00 (OUT -NE)
TFORA TED S -OUF CONNEC7701V
.L DETAIL ON Si4T tw-m)
21'-6" PVC, @
SEE TREE
ARO TE-C 77ON
NO TES ON
SHT TP-0';
GARAGE
FF 84.50
Y..
V.
88.49 4 FG.- .
89.61-
90.51±
E-0
SA. WCU T J
CB I LINE. if l
TYPE 11-48" (ryp)
SOLID.- ROUND
LOCKING LID
-z''-I-z2 -42, 16. J' L 7
RIM 88.83
6" 1E 81.60 (IN-N) EXISTING WATER-)
12 " IE 81.60 OUT- WMETER TO BE REMOVE
D. ED. Cl T Y
TO CUT & CAP
AT THE MAIN
REMOVE A NO _REP A tR EX, PA VEMEN T AS
REQ D FOR WATER INS IAI / A finAl roAtc"Imi v-7-