Issued ROW Permit.pdfOI' I,v 1��N
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20180425
RIGHT OF WAY PERM IT (I -Single Family)
Permit Number: ENG20180425 Expiration Date:
Job Address: 23305 97TH PL W, EDMONDS Location: Removal and paving of driveway
Jeremy Turner Ground Effex
23305 97TH PL W 10608 90th St NE
EDMONDS, WA 98020-5013 Lake Stevens, WA 98258
(425)239-6687
LICENSE #: GROUNEA880KI EXP: 08/09/2020
Removal and replacement of a)dsting driveway up to property fine. NO ASPHALT CUTS IN ROW.
INSRUPTION INFORMATION
ASSESSED VALUE: $0.00 PROPERTY AREA: 0
SIDEWALK: (OXO) DURATION IN MONTHS: 0 FEE: $0.00 STREET DISRUPTION TRENCH CUT: ( 0 X 0 )
PARKING: ( OXO) DURATION IN MONTHS: 0 FEE: $0.00 YEAR OF OVERLAY: 0 FEE: $0.00
ALLEY: ( OXO 1 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 ofits departments or employees, including but not limited to the defense ofany legal proceedings including defense costs and
attorney fees by reason ofgranting this permit.
THE CONTRACTOR IS RESPONSIBLEFOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONEYEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE W ORK.
• 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
possesion.
• 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 DLAI,-A-DIG (1-800-424-5555) BEFORE ANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT.1326
24 HO UR NO TIC E REQ UIRED FO R ALL INSPECTIO N REQ UESTS
THIS APPLICATION IS NOTA PERMITUNTIL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN
SPACE PROVIDED.
Printed: Mondav, March 25,201
RELEASED 81 DATE
FILE COPY F INSPECTOR COPY F APPLICANT COPY
STATUS: ISSUED
ENG20180425
• Restore ROW to City standards
• Restore Landscape to like or better conditions.
• Call for locates of underground utilities prior to any excavation.
• Alert affected residents and/or businesses prior to work start.
• Conform to approved working drawings and Traffic Control plan.
• Verify clearbore 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 fromtenporary 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 6:00pm on weekdays and 10:00am and 6:00pm 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
ham -less 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.
• E-Driveway Form & Slope Ver.
• 1--Pavement Subgrade
• E Engineering Final
PARTIAL INSPECTION DATE: INITIAL: NOTES:
PARTIAL INSPECTION DATE: INITIAL: NOTES:
FINAL INSPECTION APPROVED DATE: INITIAL.
of EOryn.
INC. 1800
ROW PERMIT NO.: ENG d ZS
ISSUE DATE: 5Z1
RIGFIT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: (A L
CONTRACTOR: �� S
Mailing Address: ff s
State License #�,Rnl{N� 0-
City Business License #: !�
ADDRESS OR INTERSECTION OF CONSTRUCTION:
CONTACT:
Phone #:
Fax #:
Email #:
Liability Insurance Bonded
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
Commercial
❑ Multi -Family
Subdivision
❑ Single Family
❑ EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit?
City Project
❑ Other
❑ Yes ❑ No
ANY ASSOCIATED PERMITS? BLD# 20(`6af'�qZ ENG#
Traffic Control (Only)
DESCRIPTION OF PROPOSED WORK (Be Specific) : P_wRIA54�a= S r! I,�••�
�'- (; F F
WAS STREET OVERLAYED WITHIN THE LAST FIVE (5) YEARS? YESIN NO ❑ Year:
PAVEMENT CUT:
CONCRETE CUT:
❑ Yes 1K No
❑ Yes ❑ No
If yes, indicate size of cut:
If yes, indicate size of cut:
x
x
RIGHT-OF-WAY
CLOSURE AREA
TOTAL
DURATION
(NUMBER OF MONTHS)
Sidewalk 48 Hrs + LF
Alley 72 Hrs + LF
X
X
LF
SF
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 requirement 'n der r e permitto be valid. q
SIGNATURE DATE
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE