106336161-1024 Bell St.pdfof EOA.104'l�
ROW PERMIT NO.: ENG
ISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: 106336161
CONTRACTOR: PSE/Infrasource
Mailing Address: 1660 Park Lane, Burlington, WA 98233
State License #: INFRASL871 C2
City Business License #: NR-023614
CONTACT: Sue Sidick
Phone #: 425-457-6353
Fax #:
Email #: Susan.Sidick@pse.com
❑ Liability Insurance ❑ Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 1024 BEII St
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
❑ Commercial ❑ Subdivision ❑ City Project ❑ Traffic Control (Only)
❑ Multi -Family ❑X Single Family ❑ Other
❑ EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit? ❑ Yes n No
ANY ASSOCIATED PERMITS? BLD# ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific) : Work area is approx 14' S c/I of Bell St &
410' W c/I of Olympic Ave to install gas service 1 3x5 paving & grass cut anticipated.
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES ❑ NO ❑ Year: 106
PAVEMENT CUT: ® Yes ❑ No If yes, indicate size of cut: 3 x 5
CONCRETE CUT: ElYes ❑ No If yes, indicate size of cut: x
RIGHT-OF-WAY
CLOSURE AREA
TOTAL
DURATION
(NUMBER OF MONTHS)
Sidewalk 48 Hrs + LF
X
LF
SF
Alley 72 Hrs + LF
X
LF
SF
Parking 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 for the permit to be valid.
°�,a�s�s a°sue
Susan Sidick °°°�s°�°s�°��«�E��.°�s��°s° 2/28/2018
SIGNATURE °�.ema'-=°.a°��°,°� .`�5 DATE
°aye: 20MMo 07.57: o-0roo
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Puget Sound Energy Gas Pre -Inspect Form
Job #:
106336161
Date:
2/15/18
Address:
Jurisdiction:
Edmonds
City / Zip:
ROW Permit:
Yes
Customer:
Est. Start Date:
4/30/18
PM / Inspector:
Est. Duration: 1 Day
1024 bell st
EDMONDS, 98020
Kell! Gaenz 425-478-6058
Kevin Williams 425-691-7673
Job Description / Scope of Work
From 2" STW main run new complete 1-1/8 PE service to single family residence(16' scat stub
New Construction:
with 36' plat
extension) set AL-425 OL
@ Inches
Yes
Construction Method
Scat ROW / Plat Property
PLAT Map:
163.067
4 Eire Hydrant
Water..
'
1-1/4 PIE Main S S C! 620
Sewer
�
-
W
I Bell ST
o
Q
"
;4�.
2" STW Main:14'S
I PE
bZOZ f5 M5
Work Location
Size of Cut
Surface Type
14'
S
I of CL
1BeI1ST
&
1 410'
W
I of CL
101ympicAVE
3x5
Asphalt/ Grass
Of CL
&
of CL
Of CL
&
of CL
Service Information
Street Information
Job Type
Diameter:
1-1/8" PE
Flaggers #:
Arterial:
New Residential Svc
EFV:
1-1/8" - 2600 - 9999144
Police #:
TCP:
Yes
Meter:
A425
Speed Limit:
25
No Parks #:
6
A, PUGEr
ENERGY
Meter Loc:
Trolley Lines:
Mtr Hoods #:
Del Press:
6" W.C.
Traffic Signal:
Bus Stop:
Bollards:
2.5" # 1 4" #
ADA Ramps #:1
1
Route #'s:
RESIDENTS) WILL BE
INFORMED OF POSSIBLE
TEMPORARY DRIVEWAY
CLOSURE
LEGEND
® 28'TRAFFIC CONE
® BORE PIT
TRAFFIC FLOW
T' —.-
WORK VEHICLE
!� SIGN LOCATION
WARNING FLAG
MINIMUM TAPER LENGTH = L (feet)
LANE
POSTED SPEED LIMITS
WIDTHS
20
25
30
35�40�475
10
70
105
150
20511
75
115
165
22512
80
125
180
245
0
CHANNELIZATION
DEVICE SPACING
TANGENT
TAPER
MPH
80
40
55/70
60
30
35/45
40
20
25/30
6-OZM
0
Bell St
11020 Bell Street c
Ne'rlie Einin
5
Cl
C
VICINITY MAP
Notes:
1.
All signs and spacing to conform to the MUTCD and City of EDMONDS
standards.
2.
All sidewalks, driveways, exits and egresses shall be completely clear
unless otherwise indicated.
3.
Channelizing devices are 28" traffic cones.
4.
Sign size can be a minimum of 48" x 48" and shall not obstruct pedestrian
SIGN SPACING
access.
55+
5.
Crew is required to leave a minimum of 11' for traveling lane width.
50
60/65
5155
4SAO
6.
Alert affected residents and businesses.
AOO
35/40
I
Work to take lace between 9 a.m. and 4 m.
P P•
30
8.
Contractor shall post temp "NO PARKING" 72 hours prior to construction.
25
9.
Work area will be 410' ECL of 0LYMPIC AVE & 14' SCL of BELL ST.
Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 008997
Card Exp. 08/13/2019
gregory.harwood@pse.com
(425)424-6425 -
PLAN PREPARED BY:
TRAFFIC MANAGEMENT, INC.
.763.3999 www.traffiemanagement.com www.trafficmanagement.com
r
Tr.ffic Control Services-Srmdr Rental.
Permits& Cansu14n8-EaAineennA•Training
C31 # 785804
TMI CONTACT PERSON: Michael 11......
TCS CERT p: 301872
PLAN ORDER: 339BB
DATE: 21281201E-RN