ENG20160454.pdfPUGET
13 Ill 17 1 SOUND
ENERGY
Job#108594408
220THSTSW 22012 76th Ave W, Edmonds, WA
__ ') ---------------- October 24, 2016
Sheet I of I ina.ustemchuk@pse.com
(425) 424-6425
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SIGN LOCATION
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LEGEND
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LEGEND
28 - TRAFFIC CONE
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BORE PIT I RIGHT LAN
RIGHT
CLOSED
TRAFFIC FLOW
------------- ----- -----------
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 I I'for traveling
lane width,
6. Alert affected residents and businesses.
7. Work to take place between 9 a.m. andAp.m.
8. Work area will be 142' SCL of 220th St SW & 18' ECL of
76th Ave W.
9. If used, place NO -PARK signs 72 hours in advance
of the day that the work is to be done.
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DEVICE SPACING
MPH TAPER TANGENT
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35/45 30 60
25/30 20 40
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SIGN LOCATION
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MPH TAPER TANGENT
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RECEIVED
OCT 2 7 2016
DE'NELOPWIENI" SERV10ES ROW PERMIT NO.: ENG —0
ISSUE DATE:
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PROJECT NAME: 108594408
CONTRACTOR: PSE/Infrasource
Mailing Address: 1660 Park Lane, Burlington, WA 98233
State License #: INFRASL871C2
City Business License #: N R-019840
CONTACT: Sue Sidick
Plione #: 425-457-6353
Fax #:
Email #: Susan.Sidick@pse.com
❑ Liability Insurance n Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 22012 76 AVE W & 220th ST SW
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
F1 Commercial Ll Subdivision F❑I City Project F1 Traffic Control (Only)
F Multi -Family FX Single Family ❑ Other
F-1 EUC (PUD, VE RIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit? El Yes W No
ANY ASSOCIATED PERMITS? BLD# ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific) : Work area is approx 142' s c/1 of 220th ST SW
& 18'E c/1 of 76th AVE W. I 3x5 paving cut anticipated. To cut and cap gas service
I WAS STREET OVERLAYED WITHIN THE LAST FIVE (5) YEARS? YESE] NO [:1 Year: 10
PAVEMENT CUT: 0 Yes ❑ No If Yes, indicate size of cut: 3 x 5
CONCRETE CUT: El Yes ❑ No If yes, indicate size of cut: _x_
RIGHT-OF-WAY
CLOSURE AREA
TOTAL
DURATION
(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) 296455-305 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 in order for the permit to be valid.
Susan Sidick s"�°"S o- "°`
P4:m•6.fan5Mfitl�.°epyy �6axb Er�c+6Y,nn5P°x�Use 10/27/2016
SIGNATURE `°""2'°.09V T3°0=�°�.��6 DATE
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE