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ROW PERMIT NO.: ENG
ISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: 108605325
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: 405 Walnut St
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 71' N c/I of Walnut St &
5' W centerline of alley way closing alleyway. to cut and cap gas service 1 3x5 paving cut anticipated
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES ❑ NO ❑ Year: 10861
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.
Susan-1 1 - o�9�,e��Y=�".S,dsks P,1111 6/6/2018
I d I cK DN at=Susan 11 " ,=di,nitlin DepaNnUS ou=Muniapal
SIGNATURE Reba��nn= emn��6133n=8 0700=e�nm �-�s DATE
Dee: 2018.06 0613:31 58-0�'00'
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
PERMIT REQUEST FORM
Date of Request: 06/06/18
Job number
Job address
Project mgr
PM email:
108605325
405 Walnut St
Gayle Plaisance
gayle.plaisance@pse.com
Estimated job start date:
Estimated job completion date:
07/27/18
Citv: Edmonds
Zip. 98020
PM contact #: (253) 617-6013
Description of work to be performed:
ri-turp 119" STXN gas sentice at main On alley (571' N('l \81alnut St, please see pre -inspect for
details (alley to be closed)
Pavement cut? FlYes ❑No
If yes, Dimensions of Cut: Length 3 Width 5
How many cuts? 1 in alley
Surface Type asphalt
Require trenching? []Yes F,/�No
If yes, Dimensions of trench: Length Width Depth
Method of installation:
Traffic impact:
Road closed
[]Yes
Q✓ No
Lane closed
Des
ENO How Many? Direction? West
Shoulder closed
Dyes
❑� No
Sidewalk closed
FYes
FNo
Emergency Contact:
Cell Number:
Job #:
108605325
PRE -INSPECTION REPORT
Date: � (o 0 5 _ [ $ Address:
Jurisdiction: Edmonds City / Zip:
Right of Way Permit? YES ❑ NO Customer:
Est. Start Date: PM / Insp:
Est. Duration:
405 Walnut St
Edmonds
®r`L-CLt''_UUNOfP:HI %`
CUST PHONE NUMBER
PHONE NUMBER
WORK DESCRIPTION: ���^- I (jam_
Rv t..� pl_e
Construction Method
V_V) r
Open Trench
Trenchless ❑
PLAT
MAP:
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Work Location
Size of Cut
Surface Tvae
6f CL At!
'N S of CL
& 'E W of CL
'N S of CL
8 'E W of CL
FLAGGERS # 2--- it MPH
❑ TROLLY LINES
❑ BUS STOP #
❑ METER HOODS #
❑
OFF CERS # SPEED LIMIT
❑ TRAFFIC SIGNAL ❑ ARTERIAL
❑ NO PARKS #
Commercial ❑ Altered Commercial
❑ Leak Repair
Service Information
❑ Template Bar
❑
Residential ❑ Altered Residential
❑ C.P Work
Diameter
Meter EFV
❑ Bollards #
❑
Multi -Family ❑ Replacement Service
❑ Pothole
❑ 5/8"
❑ 250 ❑
1800
"
❑ Bollards 4#
❑
New Constr. ❑ Main Maintenance
El Extension
❑ 11/8"
❑ 425 ❑
2600
❑
St<ib ❑ Servi Maintenance
❑ 11/4"
❑ 630 ❑
10,000 ❑ FUEL LINE PERMIT NEEDED
❑
❑
Extension ❑ ve Maintenance
Compete Sery
❑ 2"
❑l 10'00
Fuel Line Length:
Cut a Cap
Mtr Loc:
V6
Fuel Line Diameter:
5/8" PE
1991
1 1/4" PE
1993
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Maple St
LEGEND
® 28'TRAFFIC CONE
® BORE PIT
=> TRAFFIC FLOW
FLAGGER
-11- NICLE
H SIGN LOCATION
WARNING FLAG
Alder SI
y
Deck Ln
406 Walnut Street
VICINITY MAP
MINIMUM TAPER LENGTH = L (feet)
LANE
POSTED SPEED LIMITS
WIDTHS
20
25
30
35
40
45
10
70
105
150
205
295
475
11
75
115
165
225
295
495
12
BO
125
180
245
320
540
DAYTON ST
AlNO
SS300V
TO BE PLACED AT 1V001
DAYTON ST
I
� Oljjb'a ndH1
Ol
A 03SO10 0VO2
I
03S010 VI
� OVOa
N ...I
406
I
WALNUT ST
LU
Q N � NN <�=
NN b N
100'------------ ----------- --- -----------
WALNUT ST
n�
oov
W20-3
CHANNELIZATION
SIGN SPACING
DEVICE SPACING
.'"
55+
TANGENT
TAPER
MPH
800
60/65
80
40
55/70
500'
45/55
60
30
35/45
350,
200
35/40
30
40
20
25/30
100' ,
25
PUGET
• SOUND
ENERGY
Job#108605325
406 Walnut St, Edmonds, WA
May 31, 2018
Sheet 1 of 1 gregory.harwood@pse.com
(425) 424-6425
Puget Sound Energy
Traffic Control Supervisor.
Gregory Harwood
Card No. 008997
Card Exp. 0811312019
gregory.harwood@pse.com
(425)424.6425 _
Notes:
1. All signs and spacing to conform to the
MUTCO 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 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 71' NCL of Walnut St & 160'
WCL of 5TH AVE S.
PLAN PREPARED BY:
TRAFFIC MANAGEMENT, INC.
.763999
/�.
www
www.trafficmcmanagement.com
r
TrARic C" Ssrvicas • SNss $ Rentuls
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C.
Pormits$CansulOnS•FnAinssrin0 •TmininB
Cal # 785804
TMI CONTACT PERSON: Michael Flanagan
TCS CERT A: 301872
PI AN nRncR• A7RA1
neTL 9111112
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