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ENG20170240-APPLICATION.pdf�11�j ROW PERMIT NO.: ENG xn_ n ISSUE DATE: RIGHT-OF-WAY CONSTRUCTION PERMIT APPLICATION PROJECT NAME ?........c✓ (e wt vfj tit J is CONTRACTOR: Mailing- - Address: State License #: City Business License #: CONTACT: S Phone #: Fax _ ..........� Email— ❑ Liability Insuran w ... ce Bonded ADDRESS OR INTERSECTION OF CONSTRUCTION: f` ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT: Commercial �� Subdivision City Project ....... .......mO,� Traffic Control (Only) �.__.._ ❑ Multi -Family ❑ Single Family K EUC (PUD, VERIZON, PSE, MCAST, OVWSD): Is this permit part of a blanket permit? ❑ Other ❑ Yes ❑ No NY AS SOCIATED PERMITS? BLD# _ ENG# _ DESCRIPTION OF PROPOSED WORK Be Specific): t u i I 6 o © o� ._ �..............._. v i a� µ _.. �. �� ........._.... _. T OVERLAYED WITHIN THE LAST FIVE (5) YEARS YES ❑] NO � Year: WAS STREET �....... � m w._ yee C iA PAVEMENT CUT: Yes No If yes, indicate size of cut: � __ x—www_ __......- imen.; �sv1 CONCRETE CUT: J'..< Yes El No If yes, indicate size of cut: x_ 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 slat( follow all requirements in SIGNATURE tid understand the permit requirements and acknowledge that I must r/'ili permit to be valid. DATE ntractor or Agent NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Olympic View Water and Sewer District Sewer System Upgrades — Phase 2 Project City of Edmonds Right -Of -Way Permit Attachment Project Site /Address List (Pavement or Concrete Cut Dimensions): • Along 243rd PI S between 106th PI W and 107th PI W (trenchless CIPP repairs, no cuts) • Along 108th Ave W between 228th St SW and 229th PI SW (trenchless CIPP repairs, no cuts) • Along 95th PI W between 228th St SW and 224th St SW (two 101 x 5'W cuts, half pavement and half concrete sidewalk) • Along 242nd PI SW (cul-de-sac) off of 241St PI SW (101 x 5'W pavement cut) • Along 96th Ave W between 226th PI SW and 224th St SW (trenchless CIPP repairs, no cuts) • Along Edmonds Way between 100th Ave W and 102nd PI W (trenchless CIPP repairs, no cuts) • Along Robinhood Dr between Humber Ln and 106th Ave W (trenchless CIPP repairs, no cuts) • Along 234th St SW between 100th Ave W and 99th PI W (trenchless CIPP repairs, no cuts) • Along 102nd PI W between Edmonds Way and 232nd St SW (101 x 5'W cut, half pavement and half concrete sidewalk) • Next to intersection between 102nd PI W and Edmonds Way (trenchless CIPP repairs, no cuts) • Along 238th St SW between 100th Ave W and 2391h St SW (101 x 5'W pavement cut) • Along 87th PI W (cul-de-sac) off of 244th St SW (101 x 5'W pavement cut) • Along 76th Ave W between Highway 99 and 224th St SW (trenchless CIPP repairs, no cuts) • Along 236th St SW between 92nd Ave W and Edmonds Way (trenchless CIPP repairs, no cuts) CONSTRUCTION HOURS Weekdays: 7arn-6pm Saturday only: 10am-6pm No work Sundays and Federal Holidays. SEE ALSO: 0 Procedures for Obtaining Permit Approval for Tree Removal or Trimming in City Right -of -Way, dated December 9, 2002 Edmonds Community Development Code Section 18.30 Storer "mater 1' aana emC11t: -� Storm water best management practices (SMP's) shall be used to control and treat the quantity and quality of storm water before it leaves the site. Illicit discharges to storm drainage systems are prohibited. Edmonds City Code Title 7, amended by ORDINANCE NO. 3483 by the addition of Chapter 7.200 Mtgal Dischar xes to Storer Water System and Watercourses. No person shall discharge or cause to be discharged into the municipal storm drain system or any watercourse any materials, (including but not limited to pollutants or waters containing any pollutants that cause or contribute to a violation of applicable water quality standards) other than storm water, except as expressly exempted by this chapter. Civil penalties may apply to any person who fails to comply with the provisions of this chapter. The following activities do not require signature by a licensed/bonded contractor on the permit application; ➢ Trimming of tree branches using hand equipment, provided that no branches fall into traveled way (street, sidewalk, etc.). ➢ Planting of Street Trees/Landscape Features with the use of hand tools and no disruption to traffic. SAEngr\11andouts\R0W Handout.doc Revised 11/16/05 -------------- H Ag 551 Z' Ti - S ", -E 21 'F % 2 z 0 f , 2 m g" .2 X R " a 3� A. X g— A -A qMso K� gg PEI �A g- > F M� p 55 g Ull 11 A > g n, 'A S e G (D (2) G G G G P, Q Q Q HE 2-, Fsm KV t 2 M App- 0'�> A 8 5 h R b i:a P �EqIT) q M q 5 i z 0 8, z �52 4 co F8 A 2 I A g At 2 0 m m Fw z m 724. –q > > z z m AF > 3t > A 's H myzp z z m Fp. co RUM PRE99TRRRR R 9�x �5 R R F R �z m > 04 m z 's 's 6 s zz & wa m K, K,;- R 17, WiqHIM! 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