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ROW PERMIT NO.: ENG
ISSUE DATE:
MURDMID10,
'w"0110AILTV 11 M,
PROJECT NAME: 108597442
CONTRACTOR: PSE/Infrasource
Mailing Address: 1660 Park Lane, Burlington, WA 98233
State License #: INFRASL871C2
City Business License #: NR -023614
CONTACT: Sue Sidick
Phone #: 425-457-6353
Fax #:
Email #: Susan.Sidick@pse.com
F-1 Liability Insurance [:1 Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 8524 Bowdoin Way
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
F1 Commercial F-1 Subdivision El City Project F1 Traffic Control (Only)
F Multi -Family FX Single Family F-1 Other
F-1 EUC (PUD, VE RIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit? F] Yes W No
� ANY ASSOCIATED PERMITS? BLD# ENG4 I
DESCRIPTION OF PROPOSED WORK (Be Specific): Work area is approx 88' E c/1 of Summit Lane
& 14' N C/1 of Bowdoin Way to retire gas service 1 3X5 paving cut anticipated.
I WAS STREET OVERLAYED WITHIN THE LAST FIVE, (5) YEARS? YESE] NOE] Year: 108EI
PAVEMENT CUT: X1 Yes F] No If yes, indicate size of cut: 3 x 5
CONCRETE CUT: n Yes F]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 in order for the permit to be valid.
SIGNATURE Susan Sidick =! �@'� CUs=50-e&,°�
M. K160 M01:5130-0�. DATE 4/21/2017
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
-M -
LEGEND
® 28'TRAFFIC CONE
BORE PIT
TRAFFICFLO'N
WORK-WITE
SIGN LOCATION
O'YARNING FLAG
CHANNELIZATION
DEVICE SPACING
MPH TAPER TANGENT
ssno 4o Bo
35145 30 60
25/30 20 40
J;o
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 11' 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 area will be 88' ECL of Summit Ln 814' NCL of
Bovidoln Way.
9. If used, place NO -PARK signs 72 hours in advance
of the day that the work is to be done.
PUGET
ENi''
ENERGY
Job#1OB597442
Bowdoin Way & Simmit Ln, Edmonds, WA
April 19, 2017
/.�
Sheet i of 1 ina.ustemchuk@pse.com
(425) 424-6425
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 11' 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 area will be 88' ECL of Summit Ln 814' NCL of
Bovidoln Way.
9. If used, place NO -PARK signs 72 hours in advance
of the day that the work is to be done.
Project mgr:
PM email:
Gayle Plaisance
Gayle.Plaisance@pse.com
Estimated job start date:
Estimated job completion date:
Description of work to be performed:
05/15/17
06/14/17
PM contact #: (253) 617-6013
Pavement cut? ®Yes No
If yes, Dimensions of Cut: Length 3 Width 5
How many cuts? 1
Surface Type Asphalt
Require trenching? OYes FNo
If yes, Dimensions of trench: Length Width
Method of installation:
Traffic impact:
Road closed ElYes
No
Lane closed
yes
FNO
How Many? 1
Shoulder closed Wes
No
Sidewalk closed
Yes
No
Emergency Contact: Mike Blood
Cell Number: (425) 864-6154
Depth
Direction? west
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