23800 78TH AVE W.PDFIIIIIIIIIIIIII
15217
23800 78TH AVE W
02
Permit �10: 000 - i5*
C ity of Edmonds
RIGHT-OF-WAY,CONSTRUCTION PERMIT Issue Date: J-t/e -150
A. Address or Vicinity of Construction: -..AOWELL GARDEN ..23aoO 78 AV W
PERMISSION -REQUEST TO INSTALL A 2" PLASTIC MAIN TIE IN FROM
B. Type of Work (be specific):
t32'N C/L OF 238 ST SW t14'W C/L OF 78 AV W, CONTIMUE EAST TO THE PROPERTY LINE
TO ENS 23800 78 ay
PeEs"JUD TRYL8VTOMML
C. Contractor: PUGET SOUND ENERGY',","
1122 75th ST SW
Mailing Address: —
State License #:
D. Building Permit # (if applicabld):
Contact: DOUG USITALO 0
425-356-7520
Phone:
Liability Insurance: Bond:$
Side Sewer Permit # (if applicatle),.,
E. F-I Cornmerkial F .., OVWD)
Subdivision E] City Project [] EUC (PUD, GTE, PSE, CHAMBERS
Multi -Family Single Family F� Other
INSPECTOR-
F. PAVEMENT: E3 YES R NO G. 'SIZE OF CUT. x H. Charge: $
CONCRETE CUT: YES n NO
APPLICANT TO READ AND SIGN
IDEMNITY. Applicant-'� I nderstands by his/her signature to this application hel�h.e holds the City of Edmonds harmT�ssftom injuries,
damages or claims of ankkind or description whatsoever, foreseen or unfid�eseen,� 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 JS,RESPOASIBLE 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 BY CITY FORCES, AT WHICHTIMEA DEBITOR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THEAPPLICANT.
kTraffic control and public safety shall be in accord aifn`c�e w-ith,-City regulations as required by. the City Engineer. Every
flagger must be trained as required by (WAC) 296-155-305 an d must have certification verifying completion ofthe
required training in their possession.
Restoration is to be in accordance with City codes. All street -cut trench work shall be patched with aspha'lt 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.
I HA VE READ THE ABO VE STA TEMENTS AND UNDERSTAND THE PERMIT REQUIREMENT5 AND ACKNOWLEDGE
THAT I MUST MAKE THE PINK COPY OF THE PERMITA VAILABLE ON SITE ATALL TIMES FOR INSPECTIONS
Signature:
4'
e:
(Contractor or Agent)
CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK
FOR CITY USE,ONLY,�
b'. Right-of-way Fee:
Approved.
'time Authorize,
d: 'Void After' I Disruption Fee/Funq,.l 11:
Special Conditions: TQ/ fJT -WJ17_AYff UAIV Restoration Fee:
0Z1J7A&ZT&g g,.,FS �dAJ /H Total'Fee: :�:7 29-4
i29 J0. 11, LO AE - tIT Receipt No:
4& A"
('"Leilt- Jssued b
71
UPO . N COMPLETION OF PERMITTED WORK, AN ENGINEERING FINAL
INSPECTION IS REQUIRED PER CHAPTER 18.00 OF THE EDMONDS
COMMUNITY DEVELOPMENT CODE.
FINAL APPROVAL OF PERMITTED. WORK.
INSPECTOR'S SIGNATURE DATE:��Z_
For inspection requirements see Engineering Information liandout.
NO
WORK SHALL
BEGIN PRIOR
TO PERMITiSSUANCE
-ii
MEMORANDUM
Date: June 28, 2000
To: PSE - 2000-0218
From: Maryanne Zukowski Traffic Engineer
Subject: Right of Way Permit traffic control conditions of approval
Traffic Control in the Ci!y Right-of-Wa
All signs, barricades and related equipment and their use must be in accordance with
Part IV, "Traffic Controls for Highway Construction and Maintenance Operations," of
the Manual on Uniform Traffic Control Devices, as prepared by the National. Joint
Committee on Uniform Traffic Control Devices and per the City of Edmonds
Developmental Standa ' rds. Reasonable accommodations shall be made for distance
requirements in signage for geometrical conflicts. Coordination with the City Inspector
prior to all work.
Particular attention should be made to the following items:
There shall be at all times reasonable pedestrian and vehicular access to and
egress from the properties adjacent to the project, so far as possible. Contact the
affected homeowners directly to prevent conflicts.
The Public Safety Department (police and fire), 771-0200 and 771-0215, and
the Edmonds Public Works Department 771-0235 shall be notified 24 hours
prior to the lane shift for construction. Proper provisions shall be made for
public convenience, safety and travel.
Any asphalt concrete pavements, crushed surfacing, gravel base or water
required for maintaining traffic during the life of the project shall be placed by
the contractor immediately upon request by the engineer and/or inspector.
All unattended excavations.shall be properly barricaded so as to prevent
accidents.
Construction along or across the City right-of-way shall be as per the contract
documents, City of Edmonds Standards, or as directed by the engineer and/or
inspector.
City of Edmonds
NOTES: The City of Edmonds
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ID
SIZE
LENGTH
TYPE
MANUFACTURER
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360'
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GAS MAIN PRESSURE & TESTING
TYPE
TEST:
PRESSURE;
TESTED BY:
DATE
ON: / /
TIME ON:
DATE OFF: / /
TIME OFF:
DATE
ON: / /
TIME ON:
ff—AT—E OFF: / /
TIME OFF:
IDESIGN: PSIGIbYS
MAOP:
PSIG,
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CALL 1 —800-424-5555
2 BUSINESS DAYS BEFORE YOU DIG
oci Tun imnm r:np PYArT i nr.ATTnN OF FACILITIES
5
REAL ESTATE/EASEMENT
PERMIT
�,OMONQ6
3
FUNCTION
CONTACT
PHONE NO
DATE
2
ROJECT MGR:
PROJECT MGR:
0. U5 1 T LIO
11
(125) 356 -7520
06/ 0 1/,00
P OV By.
�A R ED BY .
APPROVED
p
REV#
DATE
BY
B Y
p
DESCRIPTION
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ENGR - GA -
COUNTY
NOHOM16H
6 i0M
MER SEC
Work Center
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DRAWN BY:
J. N&L)Yf�N
(125)290 -7026
06/01/ 00
REVISED BY:
1/4 SEC
6W —3t —
27— '1
OP MAP
161.071
PLAT MAP
167.079
APPROVED BY:
FOREMEN #1:
U-MAP# (POWER)
CIR MAP#
CIRCUIT#
FOREMAN #2
MAPP ING:
JOINT FACILITIES
ARRANGEMENTS
UTIL ITIES
CONTACT
PHONE#
24 MF70 Ir MAIN OXTON610N
[LU—GET fO 66""' LOWOW, WOON
SOUND
ENERGY 23600 - 76 AV W
INCIDENT#
-[FR—AwING#
SAP SUPERIOR ORDER#
107009069
SCALE: 50