244th Street_BLD20171333 PermitApplication.pdfof EDA,10
.11vc— '� 0
. 116
ROW PERMIT NO.: ENG,
ISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION
PERM IITAPPLICA,nm
PROJE CT NAME: �Lwl) 5 4
CONTRACTOR: L DP9,01i,
Mailing Address:
State License #:
City Business License H:
Bi-D
&"� 4
ADDRESS OR INTERSECTION OF CONSTRUCTION:
CONTACT: M04
y n VN;�a 0"r
Phone #: e
7 6
Fax #:
Email #: �'/ P, ou ujal,4er, Cch^n
El Liability Insui'ance B-13onded
ROW WORK ASSOPATED WITH THE FOLLOWING TYPE OF PROJECT:
Commercial P"Subdivision J_J City Project [J Traffic Control (Only)
Multi -Family 0 Single Family F] Other
[:1 EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit? El Yes 2"No
I ANY ASSOCIATED PERMITS? 1 1 BLD# 06 1-7 13 33 ENG# I
DESCRIPTION OF PROPOSED WORK (Be Specific): cL1er/',1ot1tA i*vNS)q(10L4 104
a V\ � S'e,(4_j!ec I t 15 �!!l I liq J lcj6 u , i fh M Avi 4 0 le -
IQ be LKSIA/bi Pel- CkJQP'10,JCC4 ;,)IIIAS.
WAS STREET OVERLAYED WITHIN THE LAST FIVE, (5) YEARS? YES [��rNO 0 Year: P 0 1
PAVEMENT CUT: Z/Ycs 0 No If yes, indicate size of cut: -44 'S -7 x
CONCRETE CUT: El Yes n No If yes, indicate size of cut: x
5,6e—k4c (cuAto-e�-) W, conw-w i.,\
o tq e
RIGHT-OF-WAY
AREA
CLOSURE
TOTAL
DURATION
(NUMBER OF MONTHS)
Sidewalk481-Irs+ 10() LF
Alley 72 Hrs + LF
Parking 72 Hrs + LF
X
LF1
G SF
3 �Us
X
LF
SF
X
LF
SF
APPLICANT TO READ AND SIGN
*Traffic coWrol and public safety sliall be in accordance Nvitli City regulations as required by the City
Engineer. Every flagger must be trained as reqUired by (WAC) 296-155-305 and must liave certification
verifying completion of the required training in tlieir possession.
*Restoration is to be in accordance Nvitli City codes and Standards. All street-CLIt trencli work sliall be
patclied witli asplialt or City al)proved material prior to the end of the Nvorkday — NO EXCEPTIONS.
Indemnity: The Applicant has signed an application which states helshe 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 liave read the above statements and understand the permit requirements and acknowledge tilat I must
follow all requirements in order for flie permit to be valid.
SIGNATURE — IC-e (3( , , M cvt4,i DATE 0 1
C'Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
r 5�1= \ EWa= WA 982d6-
'c Ac v Zx ax OMM200200 SASITARYSrivElc
FAW. FATM
aW3 2447M ST SW. LOT 2C
V— Va20S COP Wf.
=2-0M
ON
UjpqME cm ULPAWSKL JDUA f 462-27 1177�0,
awj 244TH 7 sw uw 2D
im ==S. 'a a2c . G 2 462.47 141
2 4w —
1 00 *51-54
e t 41LAQ I I+Sa,55, 10-L
KAWAY. cab"c 93
LOT9 2"M %T �W. tfilU 2r
3 aEGDWM(0Mr- WA VaZ"
FF-460Z 11+72�0, 167,
=1 2447H 5" SW 459M 006CIM200:00 4�OA 45209
CFF-Mj [it 141
45zO4
WA 9=& PrMC4 WJOAS J
M4
0
04
WO 244TH Sr SW,'tw 2F
go 20+74.4Z
12' Cl WA7M MWMS� WA 98206 7 4xll-, 4SZ90
(M BE
006M0002006M
4Z=
N-RACO -WiM fAT 45aW
MW 2"M ST 5w. 407 JA .9 a4L
MONOX YIA 98206 to 4a fz 45112
00668000300100
457.07 22 21+MG7- 72.
15, M5
5CWDr RqA A. W.02 27 f5.5
LOT2 W-rls'TA awr ja 32 4=02 11 94,55, 10*R
1-41-1� 006MM30= 13 4r= 454.09
OT 10- M 454.19
VA69M. DMqA L 14 4MZ7 ll+S7.4S,
iu CA\%t FF6-4"00 805 2447H Sr SK UW 3C 45420
EW01401 WA 93206 15 452M '0"G/.cq' 10 - R
0066800ax= 4--ao
I MUMS. Etwir x 4f,17
GA" 8605 244M Sr SW. =r JD 17 441.7�
MaMr, WA Moo ?a 46-217 4W.7c 10+57.4Z,
OM68002J004M
UCCLEUM. ACK
M MD= J. MAW GS = 2"TH Sr Sr/. Lgdr 3E
Ulm MVa%M WA U206
5= 244TH ST sw 4OF 0=600=5M Yj
EDUMM. WA 9505 SWARY SEM 7L
004M= 100204 &SEL07.7 8VVPFL THO)AS &
70 GYM wo 244m v sw. Leir jF
MU=Z WA .91UW
0OW00030=0 �-1 nk- r ilAc I %1 4 Lkn, c;
�OTII
IT-464M 4&.75
CFF-4&LI cf e-4 cl
-'Z� —let
H 59
w
WA7
r P.-4157 —w—,
C/L or RD 7 cup(s)-4m
CF RIW
462f111140 =NV A110 RCMU I RAD E6032
Or IX AS -HALT .462.26
244THST S.W.
L
RWDbUfr(4s3 , a -
INSTALL WHOLE
IN ACCORDANCE
WITH
DEFAIL
'.2A
7B;f
x 10- Cw(6)"54,0 C8 RM-451.80
IE 10: CW(ff)-457.2
jr 10 cup(r)-4=5 c 10: cv? .453.20
0 10 CUP N 455.0
LE ;0' CLIP -46z"o
S Y17
N
M Fa
(Al
SW 1,4. SEC 31. T, 27N.. R.04E. W.M.
MOHOWSHMMTY WASUNGTON
--------------------
Lu
<s-_5
. .... .... . 7
. . ............... .. ......
.. ............ ............ . .
<
LAW 3HPT - I:R��.�W �O�DMV
9CALE: 1- 29