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ROW PERMIT NO.: ENG
ISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: 108606715
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: 20114 83rd AVE E
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 457' S c/1 of 200th &
& 14' W c/1 of 83rd AVE W (1) 3x5 cut in grass anticipated
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES ❑ NO ❑ Year: 10861
PAVEMENT CUT: ❑ Yes ❑ No If yes, indicate size of cut:
CONCRETE CUT: ❑ Yes ❑ No If yes, indicate size of cut:
x
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 - Digiie signed ,d Suse ,1111 /� /LO
I d I cK DN at=Susan Sidi[k o=Pen@in DepaNnUS ou=Muniapal
SIGNATURE Re1a��'n' em' ��-=��=a006 0700 �nm �-Ds DATE
Deia: 2018.0] 18 13:0008-0�'00'
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
rur,cu.wu11u u1=15Y %Jaa r1c-1113Nca.L rv1111
Job #: 108606715
Date: 7/17/18 Address: 20114 83RD AVE E
Jurisdiction: Edmonds City / Zip: EDMONDS , 98026
ROW Permit: Yes Customer: RYKER YOUNG 206-930-0377
Est. Start Date: Cycle C PM / Inspector: Jordan Cooper 425-623-5302
Est. Duration: 1/2 Day (4 Hours)
Job Description / Scope of Work
Cut and Cap 3/4 ST at Main 457' S (2" STW IP 14' W 4703-1963) Gas Will Be Brought Back At New Construction:
Later Date to Serve Two Homes
Construction Method
PLAT Map: 162069 I t
I N
CUT AND CAP AT MAIN
AND REMOVE METER
Work Location
Size of Cut
Surface Type
457'
S
of CL
200th
&
14'
W
of CL
83rd Ave W
3x5
G
of CL
&
of CL
of CL
&
of CL
Service Information
Street Information
Job Type
Diameter:
0
Flaggers #:
N
Arterial:
N
Cut & Cap
EFV:
0
Police #:
N
TCP:
Y
Tie -In Fitting
Meter:
Speed Limit:
25
No Parks #:
Y
Meter Loc:
0
Trolley Lines:
N
Mtr Hoods #:
N
Del Press:
Traffic Signal:
N
Bus Stop:
N
Bollards:
2.5" # 1 4" # I
ADA Ramps #:I
N
I Route #'s:
I N
Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 008997
Card Exp. 08/13/2019
gregory.harwood@pse.com
(425)424-6425
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# 20114
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 45T SCL of 200TH St SW & 14'
WCL of 83rd Ave W.
9. If used, place NO -PARK signs 72 hours in
advance of the day that the work is to be done.
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PUGET
SOUND
ENERGY
200TH ST SW
JOB# 108606715
20114 83rd Ave W Edmonds
July 18 2018
jaber.tofan@pse.com
425-424-7808
Sheet 1 of 1
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TOW AWAY AREA
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ONE LANE O'
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--- 20210-PUSIN-----
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SIGN SPACING
MPH
"x"
60/65
1000,
45/55
500'
35/40
350'
30
200'
25
100'
CHANNELIZATION
DEVICE SPACING
MPH
TAPER
TANGENT
55/70
40
80
35/45
30
60
25/30
20
40
I LEGEND
28" TRAFFIC CONE
BORE PIT
TRAFFIC FLOW
FLAGGER
WORK VEHICLE/
FLASHING LIGHTS
SIGN LOCATION
RIGHT OF WAY
ROW
ROW
201 02 PE
199994
5/8" PE
N 1994
20035
5/8" PE
1993
20111
0 5/8" MPE
1999
20115
20114
20124
3/4" ST
1963
a
CV
4$7'S
0
608'S
460'S
480'S
272'N
20101
5/8" PE
1990
5/8" MPE
1996
20111
2011
20125
No electric grid information available Scale 1:450
S160068,Q162069
07-17-2018 Lat\Long=47.8165,-122.3457 ODQ PUGET SOUND ENERGY
The information - the attached maps b subject tb change without notice. Puget Sound Energy makes -we —ty, expressed or implied, concerning ,M( Y me •' v
the suitability of this infpnnetion for any purpose. Recipient agrees tb not disclose this confidential information tp any pth er person or entity,
unless authorized 11 writing by Puget Sound Energy. This map is not to be used for determining the actual location of any PSE facilities (,,Il 811)"