186578349-753 Bell St .pdfROW PERMIT NO. : ENG___________
ISSUE DATE: ________________
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: CONTACT:
CONTRACTOR: Phone #:
Mailing Address: Fax #:
State License #: Email #:
City Business License #: Liability Insurance Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION:
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
Commercial Subdivision City Project Traffic Control (Only)
Multi-Family Single Family Other
EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit? Yes No
ANY ASSOCIATED PERMITS? BLD#____________ ENG#____________
DESCRIPTION OF PROPOSED WORK (Be Specific) :
_________________________________________________________________________
WAS STREET OVERLAYED WITHIN THE LAST FIVE (5) YEARS? YES NO Year:
PAVEMENT CUT: Yes No If yes, indicate size of cut: _________x_________
CONCRETE CUT: Yes 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.
SIGNATURE DATE
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
753 Bell St
Edmonds
WA 98020
USA
1111
1212
11
11
10
10
STOP
FLAGGER
STOP
FLAGGER
ON
E
L
A
N
E
RO
A
D
AH
E
A
D
W20-4
100'100'100'
RO
A
D
WO
R
K
AH
E
A
D
W20-1 W20-7A
ON
E
L
A
N
E
RO
A
D
AH
E
A
D
W20-4
100'100'100'
RO
A
D
WO
R
K
AH
E
A
D
W20-1W20-7A
BE
PREPARED
TO
STOP W3
-
4
10
0
'
10
0
'
10
0
'
ROAD
WORK
AHEAD W2
0
-
1
W2
0
-
7
A
BE
PREPARED
TO
STOPW3
-
4
10
0
'
10
0
'
10
0
'
ROAD
WORK
AHEADW2
0
-
1
W2
0
-
7
A
BELL ST
8T
H
A
V
N
CHANNELIZATION
DEVICE SPACING
MPH
55/70
35/45
25/30
TAPER
40
30
20
TANGENT
80
60
40
PSE PUGET
SOUND
ENERGY
JOB#186578349
753 Bell St Edmonds, WA
5/30/2018
stephen.gadke@pse.com
425-424-6431
SHEET 1 of 1
Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 008997
Card Exp. 08/13/2019
gregory.harwood@pse.com
(425)424-6425N
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 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 approx. 112' WCL of 8th Av N
& 12' SCL of S Bell St.
BORE PIT
28" TRAFFIC CONE
LEGEND
TRAFFIC FLOW
SIGN LOCATION
FLAGGER
STOP
WORK VEHICLE/
FLASHING LIGHTS
RIGHT OF WAY
ROW ROW