ENG20160489.pdfof ISI �+
"ITY OF EDMONDS
121 5TH, AVENUE NORTH - EDMONDS, WA 98020
rr PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20160489'
RIGHT OF WAY PERM IT (6-EtJC)
Permit Number: ENG20160489 Expiration Date: 07/03/2017
Job Address: 7040 164TH ST SW, EDMONDS Location: 7040 164TH ST SW
Right of way work to place a new service drop to 7040164th ST SW. We will place drop from eiasting pole in ROW 30' to customer's
property. Work sketch and TCP is attached.
ASSESSED' VALUE: " $0,00 PROPERTY AREA: 0
SIDEWALK: ( OXO) DURATION IN MONTHS: 0 FEE $0„00 STREET DISRUPTION TRENCH CUT: ( O X 0 )
PARKING: ( OXO) DURATION IN MONTHS: 0 FEE: $0,00' YEAR OF OVERLAY: 0 FEE: $0,00
ALLEY: ( 0X0 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 ofany 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 ofgranting;th'is permit.
THE'CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD 'OF ONEYEAR FOLLOWING THEFINAL
INSPECTION AND ACCEPTANCE OFTHEWORIC
• 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
posseson.
• 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 DIALrA-DIG (1-800-424-5555) BEFORE ANY'EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT. 1326
24 HOUR NOTICEREQUIRED FOR ALL INSPECTION REQUESTS_..._
THIS APPLICATION` IS NOTA'PERMITUNTIL SIGNED BY THE CITY ENGINEER OR HIS/HERDEPUTY' AND FEES ARE PAID, AND RECEIPTIS ACKNOWLEDGED IN
SPACE PROVIDED,
Printed: Tuesday. January 03, 2017
�ZZ017
RELEASED BY DATE
FILE COPY ❑ INSPECTOR COPY 0 APPLICANT COPY
CONTRACTOR
Frontier Communications
FRONTIER COMMUNICATIONSIPACIFIC CABLE
Attn: Shelley Haugstad
CIO BRIAN SMITH
180041stStreet
1800'41 ST ST STE 100
Everett, WA 98201
EVERETT, WA 98203'
(425)263-4038
LICENSE 4: PACIFCC954PJ' EXP: 10/18/2017
Right of way work to place a new service drop to 7040164th ST SW. We will place drop from eiasting pole in ROW 30' to customer's
property. Work sketch and TCP is attached.
ASSESSED' VALUE: " $0,00 PROPERTY AREA: 0
SIDEWALK: ( OXO) DURATION IN MONTHS: 0 FEE $0„00 STREET DISRUPTION TRENCH CUT: ( O X 0 )
PARKING: ( OXO) DURATION IN MONTHS: 0 FEE: $0,00' YEAR OF OVERLAY: 0 FEE: $0,00
ALLEY: ( 0X0 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 ofany 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 ofgranting;th'is permit.
THE'CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD 'OF ONEYEAR FOLLOWING THEFINAL
INSPECTION AND ACCEPTANCE OFTHEWORIC
• 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
posseson.
• 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 DIALrA-DIG (1-800-424-5555) BEFORE ANY'EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT. 1326
24 HOUR NOTICEREQUIRED FOR ALL INSPECTION REQUESTS_..._
THIS APPLICATION` IS NOTA'PERMITUNTIL SIGNED BY THE CITY ENGINEER OR HIS/HERDEPUTY' AND FEES ARE PAID, AND RECEIPTIS ACKNOWLEDGED IN
SPACE PROVIDED,
Printed: Tuesday. January 03, 2017
�ZZ017
RELEASED BY DATE
FILE COPY ❑ INSPECTOR COPY 0 APPLICANT COPY
STATUS: ISSUED
�w Restore ROW to City standards
• Restore Landscape to like or better conditions.
0 Call for locates of underground utilities prior to any excavation.
0y Alert affected residents and/or businesses prior to work start.
w Conform to approved working drawings and Traffic Control plan.
• 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 fromthe noise limits
of ECC Chapter 5.30 only during the hours of 7:00am to 6:OOpm on weekdays and 10:00am and 6:OOpm 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 fromthe' 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.
INSPECTIONS
E-Erigmeermg Final
PARTIAL INSPECTION DATE: INITIA 1 „ , NOTES:
PARTIAL INSPECTION DATE: INITIAL: NOTES:'
FINAL INSPECTION APPROVED DATE: INITIAL:
w 1s90
RECEIVED
DfC 01 2016
DEVELOPMENT SERVICES ROW PERMIT NO.: ENC
ISSUE DATE:
RIGHT-OF-WAY T -OF -WAY CONSTRUCTION
PERMIT APPLICATION
ADDRESS OR INTERSECTION OF CONSTRUCTION
ROWCommercial Subdivision City Project . -
.. PE OF PROJECT:
n. _
K ASSOCIATED WITH THE Fd_LLOWING TY
Traffic Control (Only)
❑ Multi -Family ❑ Single Family
El EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit?
❑ Other
❑ Yes ❑ No
PERMITS? BLD# ENG# ...._.
� ANYµASSOCIATED w.
DESCRIPTION OF PROPOSED WORK (Be Specific) : Right of WaN work to place a new scrmc drop to
7040 16401 Street SW. We %till place drop loom existink pole in ROW 30' to customer's property. Work sketch and 'rcp is attached
WAS STREET t VERLAYED WITHIN THE LAST FIVES VEARS? '" S� N4
PAVEMENT CUT: ❑ Yes ❑ No If yes, indicate size of cut: x
CONCRETE CUT: Yes y ,
❑ ❑ No if es, indicate size of cut: .-��.�x
RIGHT-OF-WAY DURATION
CLOSURE AREA TOTAqSF
NUMBER OF MONTHS)
Sidewalk 48 His +
LF X LFI 2 DAYS
Alley 72 His + LF X LF SF
Parking 72 Hrs + LF X LF SF
APPLICANT TO READ AND SIGN
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*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!1 girder for the permit to be valid,.
SIGNATURE, K.,a. DATE 2- /Ze,t�
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
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NOTE;
1,FLASHING BEACON SHALL BE
INSTALLED AT EACH SIGN FOR
N04T—TIME USE,
2 DISTANCES MAY VARY AS APPROVED
BY THE ENGINEER,
].FLAGGERS REQUIRED TO CONTROL
TRAFFIC WHENEVER THE CONTRACTOR
MUST INTERRUPT TRAFFIC FLOW
TO ACCESS THE WORK SITE WITH
MATERIALS OR EQUIPMENT.
LEGEND:
Sv..Ec OR STD,. 7ONE4.1z7NR DEVNCC.
Il
RESDENTIAL STREET NTH NO CENTER LINE
LOW SPEED AND LOW VOLUME TRAFFIC
FLAGGERS TO ASSIST WI7H PEDESTRIANS
�i 1 SII' NVo L
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TRAFFIC CONTROL PLAN DATE: FTR PROJECT:
2 WAY TRAFFIC 1 LANE CLOSED 11/2016 51432 - 5122983-232
Frontier
164TH ST SW, EDMONDS, WA
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