ENG20160325.pdfPRE -INSPECTION REPORT
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FLAGGERS #
MPH
❑
TROLLY LINES
E:1 BUS STOP #
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❑ METER HOODS #
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OFFICERS #
SPEED LIMIT
❑
TRAFFIC SIGNAL
'X ARTERIAL
NO PARKS #
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Commercial
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Altered Commercial
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Manifold
Service Information
❑ Template Bar
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Residential
Altered Residential❑Main
Extension
Diameter Meter
EFV
❑ Bollards 2.5" #
E]
Multi -Family
❑
Replacement Service
❑
Pothole
E] 5/8" 250
0
775
F] Bollards 4" #
❑F]
❑New
Constr.
Main Maintenance
E]
Bollards
11/8" 425
1800
Stub
❑
Service maintenance
❑ 11/4" ❑ 630
2600
n FUEL LINE PERMIT NEEDED
Extension
❑
valve maintenance
F] 2" El 1000
Ej
10,000
Fuel Line Length:
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Compete Sery
❑
Cut & Cap
Mtr Loc: 01—
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Fuel Line Diameter:
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22018
CHANNELIZATION
DEVICE SPACING
MPH TAPER I TANGENT
55/70 40 80
35/45 30 60
25130 20 1 40
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PUGET
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SOUND.,.
ENERGY
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Job#109097123
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22018 76th Ave W, Edmonds, WA
March 2, 2016
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Sheet 1 of 2 gregory.harwood@pse.com
13 111 17
(425) 424-6425
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------
2
220TH ST SW
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........................................ ....... ....
22 I 22
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Notes:
1. All signs and spacing to conform to the MUTCD
and City of Edmonds standards.
2. All sidewalks, driveways, exits and egresses shall be
completely clear unless otherwise indicated.
3. Channelizing devices are 28" traffic cones.
4. Sign size can be a minimum of 48" x 48" and shall not
obstruct pedestrian access.
5. Crew is required to leave a minimum of Vt for traveling
lane width.
6. Alert affected residents and businesses.
7. Work to take place between 9 a.m. and 4 p.m.
8. Work areas will be near property line WCL of 76th Ave W
at 216' SCL of 220th St SW.
9. If used, place NO -PARK signs 72 hours in advance
of the day that the work is to be done.
LEGEND
® 28" TRAFFIC CONE
® BORE PIT
TRAFFIC FLOW
WORK VEHICLE
SIGN LOCATION
WARNING FLAG
I
PUGET
SOUND
ENERGY
z*"2
Job#109097123
22018 76th Ave W, Edmonds, WA
March 2, 2016
jSheet 1 of 2 gregory.harwood@pse.com
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13 I11 17
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pothole for water main rn ¢SIDEWALK
CLOSED
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---------I STOP I_____________ \.-_-__L_-__-____.
PLACE SIGN ON I
NW CORNER AT ,-
224TH ST SW j
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03SQ10
s N1VM301S ii
1
CHANNELIZATION
DEVICE SPACING
MPH TAPER TANGENT
55/70 40 80
35/45 30 60
25/30 20 40
E'
9. If used, place NO -PARK signs 72 hours in advance
of the day that the work is to be done.
RESIDENT(S) WILL BE INFORMED
OF POSSIBLE TEMPORARY
DRIVEWAY CLOSURE
'o
Notes:
1. All signs and spacing to conform to the MUTCD
16 1121 16
1
and City of Edmonds standards.
.).
2. All sidewalks, driveways, exits and egresses shall be
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SHOULDER
completely clear unless otherwise indicated.
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3. Channelizing devices are 28" traffic cones.
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1
4. Sign size can be a minimum of 48" x 48" and shall not
obstruct pedestrian access.
1
5. Crew is required to leave a minimum of 11' for traveling
•
lane width.
I • I1
•
6. Alert affected residents and businesses.
AHEAD
LEGEND
7. Work to take place between 9 a.m. and 4 p.m.
KEEP
8. Work areas will be 18' ECL to 26' WCL (in sidewalk)
•
RIGHT ;
of 76th Ave W at 216' SCL of 220th St SW.
PLACE SIGN ON I
NW CORNER AT ,-
224TH ST SW j
� Otl3Htl
03SQ10
s N1VM301S ii
1
CHANNELIZATION
DEVICE SPACING
MPH TAPER TANGENT
55/70 40 80
35/45 30 60
25/30 20 40
E'
9. If used, place NO -PARK signs 72 hours in advance
of the day that the work is to be done.
RESIDENT(S) WILL BE INFORMED
OF POSSIBLE TEMPORARY
DRIVEWAY CLOSURE
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SHOULDER
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ROAD
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WORK
AHEAD
LEGEND
® 28" TRAFFIC CONE
® BORE PIT
TRAFFIC FLOW
WORK VEHICLE
SIGN LOCATION
WARNING FLAG
- 1, i") V- 1, L, A'I o 4�
551,
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AUG 1 1 2016 ROW PERMIT NO.: ENG
CIL Vf-- - LOP-liVIL"NT ISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION PIRDEIVE'D
PERMIT APPLICA'riON
PROJECT NAME: 109097123
CONTRACTOR: PSE/Infrasource
Mailing Addi*css: 1660 Park Lane, Burlington, WA 98233
State License #: INFRASL871C2
--- - ------
City 131'silless License 9: NR -019840
Aus i,5� 2os
CONTACT: Sue Sidi(,;k
P110"efl: 425-457-6353
Fax 9:
Email #: Susan.Sidick@pse.com
---- ........... . .. . . I - --.- -- -- --- -- - -------
❑ Liabifit-
y Insurance El Bonde(I
ADDRESS OR INTERSECTION OF CONs,rRuMoN: 2
�2018 76 AVE W
ROW WORK. ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
Traffic Control (Only)
ITM Subdivision Ll City Project LJTraffic C01y11"1-1'e
rXj SillgleFamilly ❑ Othel.
El E1JC(PU1),VERIZON,PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit`? ❑ Yes No
ANY ASSOCIATED PERMITS? ENG# ---
DESCRIPTION OF PROPOSED WORK (Be Specific): Permission requested to tie into existing _
2" STW gas main located at 18' E ell of 76th AVE W & 185'S ell of 220th ST SW to extend 1 1/8 gas service to 22018 76 AVE W
1 3x5 asphalt cut anticipated 1 2x4 concrete S/W pothole over water anticipated. S/W panel to be replaced.
PAVEMENT CUT: Z Yes 0 No If yes, indicate size of cut: 3 x 5
CONCRETE CUT: ❑ Yes ❑ No If yes, indicate size of cut: ---x—
APPLICANT TO DEAD AND SIGN
"'Traffic control and public safety shall be in accordance witli City regulations as required by the City
Engineer. Every nagger 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 wmkday — NO EXCEPTIONS.
Indemnity: The Applicant has signed an application which slates he/she holm 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 acl<nowledge that i must
follow all requirements in order fir the pet -mit to be valid.
SIGNATURE DATE
��.da.. ,; .w�._ � �i�. k � . � � DATE 08/11/2016
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE