21120 212TH ST SW.PDFiiiiiiiiiiiiii
15940
21120 212TH ST SW,
LANE CLOSURE. BEYOND AN INTERSECTION
(WORK AREA ON THE THROUGH ROAD)
W20-1
AHE
ON
W20-4 muAb
HEAD
m
W20-7A
mj*
mm
a�b
CD C)
" re)
V)
0-1
COO)
SPEED
LIMIT
SIGN
SPACING
A, B,C (FT)
BUFFER
(FT)
25
200
55 -
30
200
85 -
35
350
120
40
350
170
45
500
220
50
500
280
L 55
1 500
33LJ
>7 7
0 ?_ 12-
i"'PPROVED AS NOTED
BY ENGINEERING
,,—BUFFER Tate: 617
I TAPER
—50'MIN
100, m ROAD W20-1
A
18P EA
-00-
77th PL SW
I m
0-7A
m
"ON.
wo W20-4 c
HLAU
0
W20-1
W20-1
c
I SNOHOMISH COUNTY cn
A
E
ul
EFFLnM TRAFFIC CONTROL PLAN
kPUBLIC UTILITY DISTRICT NO I
PROJECT Raise street light to get clearance for Home Land Security
D
LOCATION 21120 212th St SW Edmonds Pole number ED-90 01
ENGINEER L. Ray Rashell DAT�- 5/18/05
WO No 346810
0
PHONE— 425/783/4413
PAGER/
CELLULAR 425-290-0180/425-239-1243
Lr.
C
c
oc
LL
I A
NOHOMISH COUNTY
0
'UELIC UTILITY.DISTRICT
CONSTRUCTION OPERATIONS AND ENGINEERING REQUEST
TO
FROM
DATE
Terry Smith
L. Ray Rashell
5/10/05
ADDRESS/LOCATION/POLE NUMBER
21120 212th St SW Edmonds Pole number ED-90
MAP NO. WORK ORDER NO. DRAWING NO.
455 A 6 346810 PJ 70906
ACTION REQUESTED
'At G) pole ED-90 on the corner of 212th St SW and 77th PI W raise street light 2 feet
to get clearance for Home Land Security. Ground the street light to our system neutral.
This needs to be done 6/10/05.
6-
1125-M III -M
_I 4718 FU6�
�42
3 987 1121-M
9 7
::;
20 L-6 96_y� ]I/ 4_j
-6 296 y
191-8 - D 8-M CL- SL-32565-1 100-3542
729 ED-'89X 1120-M 0 25-30312 A-33011
7-265349 KO. SW 2-1484
00 SL-32564-D G5-65-65/12
14-25
ED-91
ED-90 FUS
4-20 4-19 p
A 4-163533
5CR 5CR
212TH ST SW 12 12 ED-92
SL-18GO-D
Goo EM-WMAY M
For do -energizing customer service for Customer work CUSTOMER CREW HOURS
When completed, call
Hie PUD at 258-8211 3 HR
(1-800-562-9142) ask
lCustomer Signature Date I for Energy Control Dispatch 1
ACTION TAKEN OR OTHER ACTION REQUIRED
-A
V D,,VV
COMPLETED BY
DATE
Distribution: WNte-D Responsible For Work-Reftim To oripiator Wnen coMatea =--u ter worK uoqnuon
Conary-&=tRisponsible For Work4b Copy
J
City of Edmonds Permit No4005_ 0/&()
RIGH.,T-OF-WAY CONSTRUCTION PERMIT Issue Date:
A. Address or Vicinity of Construction; -2- //,:?0 5w,
4
r-
B. Type of Work (be specific):
_"k-j W Nil �C'Yx k C_ �_v OT- k A N ( J-Q,-i( I v L--)
C. Contractor:,5�io/id",I/-,-;',/, rou"41
Mailing Address: /ky //,-)7
State License #:-
City ausiness License #:
D. Building Permit # (if applicable):
Contact: A - tla k I'ViS k-t I/
Phone: 7C
Liability Insurance: Bond: $
wo '6� 510
Side Sewer Permit # (if applicable):
E. F� Commercial
El
Subdivision
F1 City Project [I EUC (PUD, VERIZON, PSE, COMCAST, OVWSD)
Multi -Family
El
Single Family
�WOther Sec _o)
Q Y,( 4/ /yo-p-C
INSPECTOR:
//A iJk i
me (-&
F. PAVEMENT CUT:
YES
[I NO
G. SIZE OF CUT x
CONCRETE CUT:
El YES
[I NO
G. DQMail Approved Permit F-1 Call for Pickup
INDEMNITY. Applicant understands by hislher signature to this application helshe holds 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 but not limited to the defense of any legal proceedings including defense
costs and attorneyfees by reason ofgranting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH IS
COMPLETED BYCITYFORCES, AT WHICH TIMEA DEBITOR CREDIT WILL BEPROCESSED FOR ISSUANCE TO THEAPPLICANT,
* 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. All street -cut trench work shall be patched with asphalt or City -
approved material prior to the end of the workday — NO EXCEPTIONS.
* Three sets of construction drawings of proposed work are required with the permit application.
CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK
I HA VF��D THE ABOVE STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE
',,M
THA IMUSTM THE PIN COP Y OF THE PERMIT A VAILABLE ON SITE A T ALL TIMES FOR INSPECTIONS
Sign Lture: Date:
__ z4
I (ContracTor 6r geent)
Appro ved by: �11J I 'iZ4-
FOR- CITY US&'ONLY-
Time Authorizld: Void* -After
Special Conditions:. Ars 771 R-Fr : 1��' 0 �*yv
I— el 1 2 1 f,> A�-_ M i A, r snpz— � -P— 1 1-1 A I fC 'i
Itught,701-wa Tee:.�t�vu
. 'Diisrupihon,F&/Fiiiid,.'-.1:1-1:-
&iLluspection, Fee:..
"'Receiot,-Nv.,�.'
Issued',br,
REQUIRED INSPECTIONS: _L117�AtcF/c- CQAt-r-AOL.
Call 425-771-0220, Ext. 1326for a 24-hour
FINAL APPROVAL OF PERMITTEDWORK:
I
s
=t * equest line.
DATEiAt L6!9
C\Documents and SettingsTurtisNy Documents\Fonns\Engnmg\ROWpemit_.doc Revised 10/01/03