ROW Permit Application Recd 3-25-19.pdf0 \:L L?,11(7.
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ROW PERMIT NO.: ENG
ISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: 106352972
CONTRACTOR: PSE/Infrasource
Mailing Address: 1660 Park Lane, Burlington, WA 98233
State License #: INFRASL871 C2
City Business License #: N R-025677
CONTACT: Sue Sidick
Phone #: 425-457-6353
Fax #:
Email #: Susan.Sidick@pse.com
❑ Liability Insurance ❑ Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 926 Sea Vista PI
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
❑ Commercial ❑ Subdivision ❑ City Project ❑ Traffic Control (Only)
❑ Multi -Family ❑iC Single Family ❑ Other
❑ EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit?
ANY ASSOCIATED PERMITS?
❑ Yes ® No
BLD# ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific) : Work area is approx 21' W to 5' W to 8' E c/1 of Sea vista pl
& 502' N c/I of Sea Vista PI install gas service (2) 3x5 paving cuts and (1) 3x5 soft surface cut anticipated
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES ❑ NO ❑ Year: 1063
PAVEMENT CUT:
CONCRETE CUT:
❑ Yes ❑ No
❑ Yes ❑ No
If yes, indicate size of cut: 3
If yes, indicate size of cut: _
x5
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) 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
DATE 03/25/2019
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Job #:
Date:
Jurisdiction:
ROW Permit:
Est. Start Date:
Est. Duration:
106352972
3/6/19
EDMONDS
Yes
5/13/19
1 Day (8 Hours)
Puget Sound Energy Gas Pre -Inspect Form
Address:
City / Zip:
Customer:
PM / Inspector
926 SEA VISTA PL
EDMONDS, 98020
MARK SCHMITZ 425-508-1982
Kevin Williams 425-398-6192
Job Description / Scope of Work
From 2" PE main run new complete 1
1/8 PE service to single family home(50' scat stub with
New Construction:
Yes
40' plat extension)
Set AL-425 meter OL
@ Inches
Construction Method
cat ROW / Plat Propert
PLAT Map:
164.067
I t
N
92
L
926
3 as
L)
AL 425
{ _
r
11-118" PE
� I
921
, 4- -o a Fire Hydrant
I
5/8' PE
I
I
1986
I
5/g' PE
I
1990
10
917
ii
918
5/g' PE
a
^
1986
uu
0-
p
c�
�
coo
-=5,
2" PE h
Work Location
Size of Cut
Surface Type
21'
W
of CL
Sea Vista PL
&
502'
N
of CL
Sea Vista PL
3x5
Soft
5'
W
of CL
Sea Vista PL
&
502'
N
of CL
Sea Vista PL
3x3
Asphalt
8'
E
of CL
Sea Vista PL
&
502'
N
of CL
Sea Vista PL
3x5
Asphalt
Of CL
&
of CL
of CL
&
of CL
Service Information
Street Information
Job Type
Diameter:
1-1/8" PE
Flaggers #:
Arterial:
New Residential Svc
EFV:
1-1/8" - 2600 - 9996743
Police #:
TCP:
Y
Tie -In Fitting
Meter:
A425
Speed Limit:
No Parks #:
y
Meter Loc:
03 - OL
Trolley Lines:
Mtr Hoods #:
Del Press:
6" W.C.
Traffic Signal:
Bus Stop:
Bollards:
2.5" #
4" #
ADA Ramps #:
Route #'s:
Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 008997
Card Exp. 08/13/2019
gregory.harwood@pse.com
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.
Use traffic drums (barrels) with steady burning
Type C lights on all State Routes and Hwys.
4. Sign size can be a minimum of 36" x 36" 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
unless otherwise specified. All work for arterials
and major roadways will be from 9 a.m. to 3 p.m
8. Work area will be 21' WCL of Sea Vista PI, 5' ECL of
Sea Vista PI & 502' NCL Of Sea Vista PI.
9. If used, place NO -PARK signs 72 hours in
advance of the day that the work is to be done.
CHANNELIZATION
DEVICE SPACING
MPH
TAPER
TANGENT
55/70
40
80
35/45
30
60
25/30
20
40
TEMPORARY TRAFFIC CONTROL PLAN
-----------------
SEA VISTA PL
i
I
i
i
i
RESIDENT(S) WILL BE INFORMED
OF POSSIBLE TEMPORARY
13 113
926 Sea Vista PI
Edmonds
3020
PUGET
� SOUND
ENERGY
JOB# 106352972
926 SEA VISTA PL, EDMONDS, WA
3/12/2019
ryan.perkins@pse.com
425-424-6621
SHEET 1 of 1
LEGEND
®
28" TRAFFIC CONE
®
WORK PIT
TRAFFIC FLOW
WORK VEHICLE/
FLASHING LIGHTS
SIGN LOCATION
RIGHT OF WAY
- ROW
ROW
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