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ROW PERMIT NO.: ENG
ISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: 106341680
CONTRACTOR: PSE/Infrasource
Mailing Address: 1660 Park Lane, Burlington, WA 98233
State License #: INFRASL871 C2
City Business License #: N R-023614
CONTACT: Sue Sidick
Phone #: 425-457-6353
Fax #:
Email #: Susan.Sidick@pse.com
❑ Liability Insurance ❑ Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 19304 80 AVE W
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
❑ Commercial ❑ Subdivision ❑ City Project ❑ Traffic Control (Only)
❑ Multi -Family ❑iC Single Family ❑ Other
❑ EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit?
ANY ASSOCIATED PERMITS?
❑ Yes ® No
BLD# ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific) • Work area is approx 180' N C/I of Sierra Dr &
& 14' E - 14' W c/I of 80th AVE W to install gas service (1) U5 gravel cut anticipated and (1) concrete cut anticipated.
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES ❑ NO ❑ Year: 1063
PAVEMENT CUT:
CONCRETE CUT:
❑ Yes ❑ No
❑ Yes ❑ No
If yes, indicate size of cut: 3
If yes, indicate size of cut: _
x5
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.
-1 1 - Digiie signed ,d Suse ,1111 /��/LO
Susan
Id IcK DNtl'Susan Sidi[k,=di,nitlin DepaNnUS ou=Muniapal
SIGNATURE RD1b. nn= emn210'1'24308 0700 �nm �-Ds DATE
Deia: 2018.06 20 12:43:08-0�'00'
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 008997
Card Exp. 08/13/2019
gregory.harwood@pse.com
N4`d3Hb'
p �ibOM
adoa
X
PLACE W20-1 SIGNS ON ALL
ADJACENT STREETS WITHIN
300 FEET OF WORK AREA
x
ROAD
WORK �
AHEAD N
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MOM
avow
OV3HV X
N GVGid
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N Y X
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#19304
RESIDENT(S) WILL BE INFORMED
OF POSSIBLE TEMPORARY
DRIVEWAY CLOSURE
SIERRA DR
N a
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.
Use traffic drums (barrels) with steady burning
Type C lights on all State Routes and Hwys.
4. Sign size can be a minimum of 36" x 36" and shall
not obstruct pedestrian access.
5. Crew is required to leave a minimum of 11' for
traveling lane width.
6. Alert affected residents and businesses.
7. Work to take place between 9 a.m. and 4 p.m
unless otherwise specified. All work for arterials
and major roadways will be from 9 a.m. to 3 p.m
8. Work area will be 180' NCL Sierra Dr. & 14' WCL 80th
Ave W.
9. If used, place NO -PARK signs 72 hours in
advance of the day that the work is to be done.
PUGET
SOUND
ENERGY
JOB# 106341680
19304 80th Ave W Edmonds,WA
18th June,2018
prachi.joshi@pse.com
(425) 424-6425
1A1ST ST SWARni/F SHEET 2 of 2
�2 =>
10'V
b�9
D
MINIMUM TAPER LENGTH=L (FT.)
LANE
WIDTH
20
25
POSTED SPEED (MPH)
30 35 40 45 50
55 60
10
70
105
150
205
270
475
500
550
-
11
75
115
165
225
295
495
550
605
660
12
80
125
180
245
320
540
600
660
720
LEGEND
®
28" TRAFFIC CONE
BORE PIT
TRAFFIC FLOW
FLAGGER
WORKVEHICLE/
FLASHING LIGHTS
SIGN LOCATION
RIGHT OF WAY
ROW
ROW
CHANNELIZATION
DEVICE SPACING
MPH
TAPER
TANGENT
55/70
40
80
35/45
30
60
25/30
20
40
Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 008997
Card Exp. 08/13/2019
gregory.harwood@pse.com
�CIV71HVpom
\aVON
X
PLACE W20-1 SIGNS ON ALL
ADJACENT STREETS WITHIN
300 FEET OF WORK AREA
X
ROAD
WORKCN
o
AHEAD
*<CIVIH'
oNMom
voa.
D
#19304
7
RESIDENT(S) WILL BE INFORMED
OF POSSIBLE TEMPORARY
DRIVEWAY CLOSURE
SIERRA DR
�a
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.
Use traffic drums (barrels) with steady burning
Type C lights on all State Routes and Hwys.
4. Sign size can be a minimum of 36" x 36" and shall
not obstruct pedestrian access.
5. Crew is required to leave a minimum of 11' for
traveling lane width.
6. Alert affected residents and businesses.
7. Work to take place between 9 a.m. and 4 p.m
unless otherwise specified. All work for arterials
and major roadways will be from 9 a.m. to 3 p.m
8. Work area will be 180' NCL Sierra Dr. & 14' ECL 80th
Ave W.
9. If used, place NO -PARK signs 72 hours in
advance of the day that the work is to be done.
PUGET
SOUND
ENERGY
JOB# 106341680
19304 80th Ave W Edmonds,WA
191.RT .ST .SI/1/ ARni/F
MINIMUM TAPER LENGTH=L (FT.)
LANE
WIDTH
20
25
POSTED SPEED (MPH)
30 35 40 45 50
55 60
10
70
105
150
205
270
475
500
550
-
11
75
115
165
225
295
495
550
605
660
12
80
125
180
245
320
540
600
660
720
18th June,2018
prachi.joshi@pse.com
(425) 424-6425
SHEET 1 of 2
CHANNELIZATION
DEVICE SPACING
MPH
TAPER
TANGENT
55/70
40
80
35/45
30
60
25/30
20
40
Job #:
Date:
Jurisdiction:
ROW Permit:
Est. Start Date
Est. Duration:
106341680
6/15/18
Edmonds
Yes
8/20/18
1-112 Days
Puget Sound Energy Gas Pre -Inspect Form
Address:
City / Zip:
Customer:
PM / Inspector:
19304 80TH AVE W
EDMONDS, 98026
TREVE HAIST 206-683-5200
Jordan Cooper 425-623-5302
Job Description / Scope of Work
From 2" STW IP 14' E ( 5226-1963) Run Scat PE 1 1/8 Service To Single Family Home 75' (40'
New Construction:
Stub & 35' Ext)
and Set A250 OR. Please
see Attached City Of Edmonds GIS Map
Construction Method
All Scat / Trenchless
PLAT Map:
161069
P/L
I
A250 MSA
® 1-1/8" PE I
I I l
I
19304
I
I II
I
I :l
I
I
I
P/L
I II
I II
I II
6" EXISTING Sewer
6" EXISTING Water 3
I I
d
I
24" CMP EXISTING Storm L
L�
00
..................:............................:............... ...... ...:... ...;...
;...... .........:............. .. ... .. ...
..................:.........;...................:.......
...... .
. .
. . . . . . .
Sierra Dr
. . . . . . . . . . . . .
I
I
I
Work Location
Size of Cut
Surface Type
180'
N
of CL
Sierra Dr
&
14'
E
of CL
80th Ave W
3x5
Gravel
180'
N
of CL
Sierra Dr
&
14'
W
of CL
180th Ave W
3x5
C
Of CL
I
&
of CL
Service Information
Street Information
Job Type
Diameter:
1-1/8" PE
Flaggers #:
Y
Arterial:
N
New Residential Svc
EFV:
1-1/8" - 2600 - 9999144
Police #:
N
TCP:
Y
PUGET
SOUND
® ENERGY
Meter:
A250
Speed Limit:
25
No Parks #:
Y
Meter Loc:
08 - OR
Trolley Lines:
N
Mtr Hoods #:
N
Del Press:
6" W.C.
Traffic Signal:
N
Bus Stop:
N
Bollards:
2.5" # 1 1 4" # I
ADA Ramps #:I
N
I Route #'s:
I N