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ENG20130242.PDFOF EDAj ° CITY OF EDMONDS 121 5TH AVENUE NORTH - EDMONDS, WA 98020 In 1890 PHONE: (425) 771-0220 - FAX: (425) 771-0221 C. *PERMIT MUST BE POSTED ON JOBSITE* STATUS: ISSUED ENG20130242 RIGHT OF WAY PERMIT (7-EUC Standard) Permit Number: ENG20130242 Expiration Date: 07/09/2013 Job Address: 16200 75TH PL. W, EDMONDS Location: APPLICANT CONTRACTOR COMCAST OF WA, LLC SEFNCO 1525 75TH AVE SW 12303 Cyrus Way Attn: Betty EVERETT, WA 98203 Mukilteo, WA 98275 (253)405-5788 LICENSE #: EXP: 1: Bore/trench in the shoulder of the ROW approx 60 ft from pole and set a carson to extend and bury CATV service drop to 16200 75th PL W NO pavement or concrete cuts Comcast Job #: 466201 DISRUPTION INFORNIATION ASSESSED VALUE: $0.00 PROPERTY AREA: 0 SIDEWALK: (OXO) DURATION IN MONTHS: 0 FEE: $0.00 STREET DISRUPTION TRENCH CUT: (OXO) PARKING: (OXO) DURATION IN MONTHS: 0 FEE: $0.00 YEAR OF OVERLAY: 0 FEE $0.00 ALLEY: ( OXO ) DURATION IN MONTHS: 0 FEE: $0.00 INDEMNITY.- The Applicant has signed an application which states he/she 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 attorney fees by reason of granting 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. 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 NOT A PERMIT UNTIL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND SPACE PROVIDED. Printed: Friday, May 10, 2013 /io/i_3 BY COPY ❑ INSPECTOR COPY ❑ APPLICANT COPY STATUS: ISSUED ENG20130242 • Restore ROW to City standards • Restore Landscape to like 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. • Construction hours are Monday -Friday 7am-6pm and Saturdays 10am-6pm. No work on Sundays or Federal Holidays. • Call for required inspections as noted. • 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 7:00am to 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 indemnify defend and hold harmless 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 fo 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-Engineering Final PARTIAL INSPECTION DATE: INITIAL: NOTES: PARTIAL INSPECTION DATE: INITIAL: NOTES: FINAL INSPECTION APPROVED DATE: INITIAL: ■ CL 1 (n ui 2 c 6 M (D (1) 0 CL 16 "a a) CL C: En (n :F .0 *6 Q) 7 co U) 2 c 0 M) D CL 0 t 0 C) C, C 0 W :t� M �O 0 LO 2 0 0 0 (D .0 0 0 7 > 0 Q U) CL L) G *0 zo a) (n a a> 2 a) cn M t: cal) =0 O. E2 'n c M 0 :3 2 c E 7E 0 4) E 0) > E i U) 0 -0 M a (n 2 2 mo '2� 'E a) C 0) (D 0 0 0 L) 0 cu 0 0 0 Cc '0 U) (D C CL a) r- 4-j cn CL M a) CL o 2 :03 0 r 'a0 C (D E 0> ' (D P P6, aJ C ic .. 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RIM QCC a 73 :3 n s a 3 3a � 2 v� u a�Xi ti l i i o '` a o — Q z >D o z V Z O m v 9 c w c o « a o m = v � m A o 45 c m E m o .q m= w o u L T o g �A C O W m gQ � N d s " O C« 2 O. zz N O N O w g a O z U N Z � g U S o p w w V= LU c a 3 a a C - y v„ i - n v a m 3 m O N e —c tr*_a. IIVC. S*J0 ROW PE IT NO.: ENG ISSUE DATE: RIGHT-OF-WAY CONSTRUCTION PERMIT APPLICATION PROJECT NAME: Comcast job #466201 CONTRACTOR: SEFNCO Communications Mailing Addrgss• 12303 Cyrus Way Mukilteo, WA 98275 State License I#: SEFNCI*994P9 City Business License #: NR-016074 CONTACT: Vicki Burns (Comcast)/Beverly Pierce (SEFNCO) Phone #: 425-263-5461/253-299-8602 Fax #: j Email #: Vicki_Burbs2@cable.comcast.com BeverlvPOSefnco corn 0 Liability Insurance [E Bonded ADDRESS OR INTERSECTION OF CONSTRUCTION: 16200 75th PI W. ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT: Commercial ❑ Subdivision ❑ City Project Traffic Control (Only) ❑ Multi -Family ❑ Single Family ❑ Other R EUC (PUD, VERIZON, PSE, RECEIVED COMCAST, OVWSD): APR 2 2 2013 Is this permit part of a blanket permit? ❑ Yes © No I)EVELOPMENT-GERMeES ANY ASSOCIATED PERMITS? BLD# ENG# DESCRIPTION OF PROPOSED WORK (Be Specific) : --]Bore/trench in the shoulder of the ROW approx 60 ft from pole and set a Carson to extend and bury CATV service drop to 16200 75th PI WAS STREET OVERLAYED WITHIN THE LAST FIVE (5) YEARS? YES Ll NO Ll 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 DURATION AREA TOTAL CLOSURE (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 i Lrfor the perm be valid. SIGNATURE DATE Contractor o Agent NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE RIGHT OF WAY CONSTRUCTION.PERMIT"ROUTING FORM PERMIT #: fNki 74)13 O 7y 7- RECEIVED: WORK ADDRESS: R(oUb --7C4h OL w CONTRACTOR: GO1 e4"—( THIS PERMIT_ IS TRACKED BY PERMIT TRAX Please remember the following: "Sign off" on permit under your specific review and Check Complete Box. OR Attach Review Corrections in Permit Trax. • Corrections will be sent to the applicant by Engineering Reviewer. • Note "Corrections attached" under your specific review. • Re -assign your review to the Engineering Reviewer. Track Review Time under your specific review. Add Conditions that need to show on the permit document. Add a Message if you need to flag other reviewers of a specific project issue/concern. PUBLIC- W.ORKS'REVIEW DATE:RECEIVED: STREET DIVISION -------------------------Date Review Complete: -------------------------- STORM DIVISION _ Date Review Complete: ❑ WATER DIVISION -------------------- ------Date Review Complete: ❑ SEWER DIVISION -------------------------- Date Review Complete: S�—��-- Y�.,PW DIRECTOR -----------------------------Date Review Complete: ,� 1 fJ EXX, — MI SS I LWA Seti►om .4 STorL#4 (_Oo rr 60- ertiu I A00 70 lot^ft) PLANNING: REVIEW ,REQUIRE D:ON-ALL WIRELESS FACILITIES I (cell antennas, unicell,.etc.) Date Received: Date Review Complete: N N N RETURN TO ENGINEERING REVIEWER a N N Comments made on the attached documents need to be done with a RED PEN and on ALL 3 COPIES. -Date and initial all chanaes or comments. ❑ FRANCHISE FEES REQUIRED: $ (COLLECT PRIOR TO ISSUANCE.) ❑ COPY OF PERMIT TO SANDY CHASE, CITY CLERK CAMy Documents\Spellman\Forms\Jana's ROW Routing 3-07.doc Revised 5-11-10