6.6.19- Issued Permit (2).pdf0 V. E 1) Lf,
A� A
CITY OF EDMONDS
1215THAVENUENORTH- EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20190185
RIGHT OF WAYPERM IT (3-Comme rcial)
Permit Number: ENG20190185 Expiration Date: 09/06/2019
Job Address: 22625 FHG14WAY 99, EDMONDS
ANTEA GROUP
CIO JACOB KNAPP
4006148THAVENE
REDMOND, WA 98052
Location: Highway 99, near 22625 Hwy 99
ANTEA GROUP
CIO JACOB KNAPP
4006 148TH AVE NE
REDMOND, WA 98052
(651) 697-5253
LICENSE #: EXP:
Antea Group is the environmental consulting firm conducting environmental remediation and monitoring work at the gas station
located at 22625 Highway 99 in Edmonds, WA. The Pollution Liability Insurance Agency is requesting that we complete three soil
borings to collect soil and groundwater samples in Highway 99, near our site mentioned above. Each boring will be —8" diameter, drilled
to 75 feet below ground surface. We estimate it will take 5-6 days to complete,
abandon, and patch the borings. Maps with the proposed boring locations and traffic control plans are attached.
DISRUTTION INFORMATION
ASSESSED VALUE $0 00 PROPERTY AREA 0
SIDEWALK: (OXO) DURATION IN MONTHS: 0 FEE: $0 00 STREET DISRUPTION TRENCH CUT: 0 x 0
PARKING: ( OX0 DURATION IN MONTHS 0 FEE: $0 00 YEAR OF OVERLAY: 0 FEE: $0 00
ALLFY: I OX0 DURATION IN MONTHS: 0 FEE: $0.00
IIVDEMATTY- The Applicant has signed an application ivhich states helshe holds the City ofEdmonds harmlessfrom injuries,
damages or claims ofany kind or description ivIialsoeverforeseen or unforeseen, that may be made against the City ofEdmonds or
any ofits departments or employees, including but not limited to the defense ofany legal proceedings including defense costs and
afforneyfees by reason ofgranting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONEYEAR FOLLOWING THEFINAL
INSPECTION AND ACCEPTANCE OF THENVORK
• 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
possesion.
• 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) BEFORE ANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT. 1326
24 HOUR NOTICE REQUIRED FOR ALL INSPECTION REQUESTS
THIS APPLICATION IS NOTAPERMITUNTIL SIGNED BY THE CITY ENGINEER OR HISMER DEPUTY: AND FEES ARE PAID, AND RECEIPTIS ACKNOWLEDGED IN
SPACE PROVIDED.
Printed: Thursday. June 06.201
FIFILECOPY F-] INSPECTOR COPY F-] APPLICANT COPY
STATUS: ISSUED
ENG20190185
• Restore ROW to City standards
• Restore Landscape to Eke or better conditions.
• Call for locates of underground utilities prior to any excavation.
• Alert affected residents and/or businesses prior to work start.
• Conform to approved working drawings and Traffic Control plan.
• Public utilities maintain 5'separation from City Utilities.
• Verify clear bore crossings
• Utility patch restoration to be in accordance with Edmonds Standard detail E2.3
• Maintain erosion & sedimentation control. Keep street clean.
• Call for required inspections as noted.
• Traffic Control per approved plan and MUTCD. Refer to City of Edmonds traffic control requirements.
• Applicant shall repair/replace all damage to utilities or frontage improvements in City right-of-way per City standards that is
caused by or occurs during the permitted project.
• Sound/Noise originating from temporary construction sites as a result of construction activity are exempt from the noise limits
of ECC Chapter 5.30 only during the hours of 7:00amto 6:00pm on weekdays and 10:00am and 6:00pm on Saturdays, excluding
Sundays and Federal Holidays. At all other times the noise originating from construction sites /activities must comply with the
noise limits of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120.
• Applicant, on behalf of his or her spouse, heirs, assigns, and successors in interests, agrees to inderrmify defend and hold
hanrdess the City of Edmonds, Washington, its officials, employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the issuance of this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirements of any City ordinance not limit in any way the City's ability to enforce any ordinance
provision.
• E-Traffic Control
• E-CDF Tickets
• EEngineering Final
PARTIAL INSPECTION DATE: INITIAL: NOTES:
PARTIAL INSPECTION DATE: INITIAL: NOTES:
FINAL INSPECTION APPROVED DATE: INITIAL:
I& 6._1 S 9 0
�Vvl V00011111
RIGHT-OF-WAY
ROW PERMIT NO.: ENG,,7,019 0 1 &5
ISSUE DATE:
CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: Soil Borings Highway 99
CONTRACTOR: Antea Group
CONTACT: Jacob Knapp
Phone#: 651-697-5253
Mailing Address:4006 148th Ave NE Redmond WA 98052 Fax #:
State License #: 601092512 Email #: jacob.knapp@anteagroup.com
City Business License #: NR-027044 [_X1 Liability Insurance F-1 Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: Highway 99, near 22625 Hwy 99, Edmonds, WA
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
F-1 Commercial F-1 Subdivision F-1 City Project F-1 Traffic Control (Only)
F-1 Multi -Family El Single Family
F-1 EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this pennit part of a blanket permit?
N Other
El Yes FX No
I ANY ASSOCIATED PEFAUTS? I BLD# ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific):
Antea Group is the environmental consulting firm conducting environmental remediation and monitoring work at the
gas station located at 22625 Highway 99 in Edmonds, WA. The Pollution Liability Insurance Agency is requesting that we
complete three soil borings to collect soil and groundwater samples in Highway 99, near our site mentioned above. Each
boring will be —8" diameter, drilled to 75 feet below ground surface. We estimate it will take 5-6 days to complete,
abandon and patch the hnringq- Mnps with the propnsed horing loratious and traffic rantral plans are attached
I WAS STREET OVERLAYED WITHIN THE LAST FIVE (5) YEARS? YESE] NOD Year:
PAVEMENT CUT: E] Yes F� No If yes, indicate size of cut: x
CONCRETE CUT: E] Yes F-1 No If yes, indicate size of cut: x (Three I'x I'
concrete cuts
will be needed,
one for each
boring
location.)
RIGHT-OF-WAY
AREA
CLOSURE
TOTAL
DURATION
(NUMBER OF MONTHS)
I
Sidewalk 48 Hrs + LF
X
LF1
LF
SF
Alley 72 Hrs + LF
X
SFJ
Parking 72 Hirs + LF
X
LF
SFJ
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 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 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 42ez &2L DATE 4/4/19
Contra��ror Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
wwwaltustroffic.c
REQUESTED DATES: ADDRESS: PERMIT:
WORK HOURS: — 22626 WA-99, Edmonds, WA 98026 1
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REQUESTED DATES: ADDRESS: PERMIT:
WORK HOURS: 22625 WA-99, Edmonds, WA 98026 1
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Left Lane Closure
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Summary of Devices
4::' Road Work Ahead
4 ' Left Lane Closed Ahead
1 - 4111" Transition Symbol
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Location: 22626 WA-59
Edmonds, WA 98026
For: Antea Group
N:me: Grace Hilbert 42&496-7716
t) tc: November 6, 2011
Dr. By: Matt Hitchcock
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Proposed Soil Boring Location
Monitoring Well Location (Exsiting)
Monitoring Well Location (Delta 2010)
Abandoned/Destroyed Monitoring Well Location
A Soil Vapor Extraction Well Location (Delta 2010)
Air Sparge Well Location (Delta 2010)
Proposed Injection Well Location
(g) Soil Boring Location (CDM, 2001)
A Soil Boring Location (KHM, 2001)
-�-Soil Boring Location (ATC, 2007)
LAW"
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M
171
7. SM1
FIGURE 2
Site Map
ELT/COP SITE NO. 2705927
22625 HIGHWAY 99
EDMONDS, WASHINGTON
PROJECT NO. PREPARED BY REP SCALE
142705927 MBISAA 1360
DAT E REVIEWED BY MAP SCALE
10/17/2016 X I inch = 30 feet
%L
antea'group
Notify WSDOT authorities 48-72 hours in advance of construction. Contact Bonnie Nau at (206)
440-4471.
* Contractor is responsible for complying with WSDOT trenching and restoration standards under
RCW 47.24.020(4)(5) and -the Utilities Manual Section 120.02. WSDOT's main concerns are to
preserve the integrity and intended lifespan of the pavement.
* Core paved surfaces prior to augering, probing, or potholing to prevent damage from the drilling
equipment action.
* Do not locate boreholes, probes, or potholes in the wheelpath, where pavement conditions
deteriorate fastest. The center or edge of lane is preferred.
* Comply with the minimum standards set forth in WAC 173-160-400 (borings) or the attached
restoration detail (potholes).
* Restore surface to match existing pavement profile (e.g. concrete, pavement, or pavement over
concrete) in accordance with WSDOT Standard Specifications.
* Call for locates.
0 Must maintain a minimum of 5' horizontal and V vertical separation from city utilities - water,
sewer & stormwater.
CROSS SECTION A -A
NTS
LEGEND
EXISTING HMA (HOT MIX ASPHALT) OR PCCP (PORTLAND CEMENT CONCRETE PAVEMENT).
HMA CLASS % INCH OR PCCP: DEPTH AND MATERIAL SHALL MATCH EXISTING PAVEMENT. REMOVAL AND REPLACEMENT
LIMITS OF PAVEMENT TO BE DETERMINED AT THE TIME OF UTILITY PERMIT/FRANCHISE REVIEW.
G CDF (CONTROL DENSITY BACKFILL).
EXISTING CRUSHED SURFACING BASE COURSE.
CRUSHED SURFACING BASE COURSE DEPTH SHALL MATCH DEPTH OF EXISTING CRUSHED SURFACING BASE COURSE.
0 HNIA BUTT JOINT REQUIRES TACK, SEAL, AND SAND. FOR PCCP, REFER TO GENERAL NOTE S.
0 EXISTING MATERIAL.
EDGE OF PAVEMENT
................. ..................
GENERAL NOTES
I .
COMPACTION SHALL BE METHOD "C" PER STANDARD SPECIFICATION SECTION 2-03.3(14)C.
I.
OPEN CU SHOULDER
2.
PCCP SHALL BE REPLACED TO THE NEXT PANEL JOINT IN EACH DIRECTION AS APPROVED BY
POTHOLE
WSDOT. ALL WORK SHALL BE AS SPECIFIED IN WSDOT STANDARD SPECIFICATION SECTION S-01.3(4).
3.
TACK ASPHALT PER WSDOT STANDARD SPECIFICATION 5-4.3(5)A.
EDGE OF LANE
4.
ALL POTHOLES SHALL BE VERTICAL AND NO LARGER THAN 12" DIAMETER.
5.
ALL POTHOLE LOCATIONS SHALL HE BACKFILLED AS DESCRIBED IN THE LEGEND SECTION ABOVE.
------ ........ .......
6.
ALL POTHOLES SHALL BE VACTORED USING AIR ONLY; HYDRO EXCAVATION AND WATER -JETTING SHALL
NOT BE ALLOWED.
7.
ALL POTHOLE LOCATIONS SHALL BE 5' MINIMUM AWAY FROM THE NEXT NEAREST POTHOLE.
SHOULDER P,
.................. OPEN CUT DETAIL
PLAN VIEW FOR POTHOLE
14TS