ROW permit application.pdf
ROW PERMIT NO. : ENG___________
ISSUE DATE: ________________
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: CONTACT:
STONEBRIDGECOURT
MikeJohnson
CONTRACTOR:Phone #:
Universal-LandConstructionCo.,Inc.
425-754-3321
Mailing Address: Fax #:
POBox329,Woodinville,WA.98072
State License #: Email #:
mikej@uni-land.com
UNIVELC159RL
City Business License #: Liability Insurance Bonded
X
NR-017519
ADDRESS OR INTERSECTION OF CONSTRUCTION:
7723&7807220thSt.SW
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
Commercial Subdivision City Project Traffic Control (Only)
X
Multi-Family Single Family Other
EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Yes No
Is this permit part of a blanket permit?
ANY ASSOCIATED PERMITS?
BLD#____________ ENG#____________
DESCRIPTION OF PROPOSED WORK (Be Specific) :
Frontageimprovementsandutilityextensionsasshown
ontheapprovedplanstoservetheproposedsubdivision.
_________________________________________________________________________
WAS STREET OVERLAYED WITHIN THE LAST FIVE (5) YEARS? YES NO Year:
PAVEMENT CUT: Yes NoIf yes, indicate size of cut: _________x_________
CONCRETE CUT: Yes NoIf yes, indicate size of cut: _________x_________