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Washington State Department of Transportation Utility Permit - FranchiseWashington State
Department of Transportation
Douglas B. MacDonald
Secretary of Transportation
January 11, 2005
Mr. Noel F. Mille, P.E.
Public Works Director
City of Edmonds
121 5th Avenue North
Edmonds, WA 98026
Subject: SR 104, MP 25.25 to MP 25.81
Existing 24" RCP Sanitary Sewer Main
Utility Franchise #5104 Renewal
Dear Mr. Miller:
Northwest Region
15700 Dayton Avenue North
P.O. Box 330310
Seattle, WA 98133-9710
206-440-4000
TTY: 1-800-833-6388
www.wsdot.wa.gov
Please find enclosed your completed utility franchise renewal. This franchise will remain
in effect for a 25-year period. Prior to the end of this 25-year period this franchise will
require renewal to avoid delays in providing service connections or other infrastructure
requirements.
When routine maintenance becomes necessary, please contact the local WSDOT Area
Maintenance Office listed below. Emergency repairs should be reported to the
Maintenance Office no later than 24-hours after the emergency has been identified and
repairs undertaken.
709 N Broadway
Everett, WA 98206
Phone (425) 339-1780
If you have any questions regarding your application, please contact me at (206) 440-
4134.
Sincerely,
Aziz Makari
Utility Accommodation Engineer
ASM: asm
Enclosures
Cc: Mel Reitz, Area 3 Maintenance
File
RECEIVED
JAN 1 8 2005
EDMONDS CITY CLERK
�oN—S--5'z
l-� D /-6-20's[J
� 36,35
Vim' D Ito �„ �„ Application for Utility Permit or Franchise
Pelt/Franchise No. F5104R
Applicant - Please print or type all information If
Application is Hereby Made For: ❑ Permit ❑ Category 1 $500.00
❑ Franchise ❑ Amendment ❑ Category 2 $300.00
❑ Franchise Consolidation $300.00 ❑ Category 3 $150.00
® Franchise Renewal $250.00
Intended Use of State Right of Way is to Construct, Operate, and Maintain a:
24" RCP Sanitary Sewer Main on a portion of
State Route 104 (attfrom) Mile Post to Mile Post 25.81 in Snohomish County,
to begin in the NE'/4 SE'/4 Section 26 Township 27 N North: Range 3 E West(East W.M.
and end in the SW '/4 SW 1/4 Section 25 Township 27 N North: Range 3 E West/East W.M.
Fees in the amount of $ Z50.00are paid to defray the basic administrative expense incident to the processing of this
application according to WAC 468-34 and RCW 47.44 and amendments. The applicant further promises to pay additional
costs incurred by the Department on the behalf of the applicant.
Checks or Money Orders are to be made payable to "Washington State Department of Transportation."
City of Edmonds
Applicant (Referred to as Utility) Applicark Authorized
7110 - 210' St. SW Noel F. Miller, P.E.
Address Print or Type Name
Edmonds WA 98026 Public Works Director
City State Zip Code Title
425-771-0235 Dated this 2(p fil day of oc+obey , 'Zna 4
Telephone
91-6001244
Applicant Reference (WO) Number Federal Tax ID or Social Security Number
yr i t;•a'r <; IS3si-�;' Authorization to Occupy Only If Approved Below '
The Washington State Department of Transportation referred to as the "Department," hereby grants this document (Permit or Franchise as
applicable) subject to the terms and conditions stated in the General Provisions, Special Provisions, and Exhibits attached hereto and by this
reference made a part hereof: Construction facilities proposed under this application shall begin within one year and must be completed
within three years from date of approval.
7rlr4 r k ,}.a�,9 ON
For Department Use Only
Exhibits Attached Departm Approval
EXHIBIT "A" _ Special Provisions for Permits By; r,,
and Franchises, pages 1-3
EXHIBIT `B" _ Utility Facility Description t
Farm, page I -1 2
EXHIBIT "C" —Right of Way, page I-� Title: c, ✓O�t�
Date: Q I • �b • ds
EXHIBIT "D" —Utility Plan Sheet, pages I -�
E AWV- -Nrk&/c,6i*bf PXdd Iprd/Y--ll/1/
Expiration Date: 01/06/2030
MS Word simulation of DOT Form 224-696 EF
Current as of 10-23-2000
AWL
Washington State
V. Department of Transportation
Franchise No. 5104 Renewal
Special Provisions for
Permits and Franchises
Applicable provisions are denoted by ( ® )
® 1. No work provided for herein shall be performed until the Utility is authorized by the following Department representative:
Mel Reitz, Area 3 Assistant Maintenance Superintendent
709 N Broadway
Everett, WA 98206
Phone (425) 339-1780
e-mail: reitzm@wsdot.wa.gov
® 2. A copy of the permit or fran rhise must be on the job site, and protected from the elements, at all times during any of the construction
authorized by said permit/franchise.
® 3. In the event any milepost, right of way marker, fence or guard rail is located within the limits of this project and will be disturbed during
construction, these items will be carefully removed prior to construction and reset or replaced at the conclusion of construction to the
satisfaction of the Department. All signs and traffic control devices must be maintained in operation during construction.
® 4. Prior to construction, the Utility shall contact the Department's representative (listed under Special Provision Number 1) to ascertain the
location of survey control monuments within the project limits. In the event any monuments will be altered, damaged or destroyed by the
project, appropriate action will be taken by the Department, prior to construction, to reference or reset the monuments. Any monuments
altered, damaged or destroyed by the Utility's operation will be reset or replaced by the Department at the sole expense of the Utility.
19 5. During the construction and/or maintenance of this facility, the Utility shall comply with the Manual on Uniform Traffic Control Devices for
Streets and Highways (Federal Highway Administration) and Washington modifications thereto. If determined necessary by the
Department, the Utility shall submit a signing and traffic control plan to the Department's representative for approval prior to construction or
maintenance operations. No lane closures shall be allowed except as approved by the Department representative. Approvals may cause
revision of special provisions, including hours of operation.
® 6. Any changes or modifications to the approved franchise/permit shall be subject to prior review and approval by the Department. The Utility
shall notify the Department's representative upon completion of the work under this permit/franchise so that a final inspection can be made
and shall immediately fumish to the Regional Utilities Engineer a revised franchise or permit plan of the final location or relocation of its
facilities if the original permit/franchise plans have been revised during the course of construction.
® 7. Prior to the beginning of construction, a preconstructlon conference shall be held at which the Department and the Utility and utility's
engineer, contractor, and Inspector shall be present.
® 8. Should the Utility choose to perform the work outlined herein with other than its own forces, a representative of the Utility shall be present
at all times unless otherwise agreed to by the Department representative. All contact between the Department and the Utility's contractor
shall be through the representative of the Utility. Where the Utility chooses to perform the work with its own forces, It may elect to appoint
one of its own employees engaged in the construction as its representative. Failure to comply with this provision shall be grounds for
restricting any further work by the Utility within the State right of way until said requirement is met. The Ulility, at its own expense, shall
adequately police and supervise all work on the above described project by itself, its contractor, subcontractor, agent, and others, so as not
to endanger or injure any person or property.
® 9. The Utility agrees to schedule the work herein referred to and perform said work in such a manner as not to delay the Department's
contractor in the performance of his contract.
® 10. Work within the right of way shall be restricted to between the hours of 9:00 AM and 3:30 PM , and no work
shall be allowed on the right of way Saturday, Sunday, or holidays, unless authorized by the Department. Any lane closures must be
submitted for approval in advance of use. The hours of permitted closure may differ from the above noted hours.
® 11. If determined necessary by the Department, any or all of the excavated material shall be removed and replaced with suitable material as
specified by the Department.
® 12. Wherever deemed necessary by the Washington State Department of Labor and Industries and/or the Department for the safety of the
workers and the protection of the highway pavement, the sides of the trench (or excavation) shall be adequately supported to reduce the
hazard to workers and prevent any damage by cracks, settlement, etc., to the pavement. No other work in the trench or excavation area will
be allowed until this requirement is met.
® 13. All trenches, boring or jacking pits, etc. shall be backfilled as soon as possible and not left open during non -working hours unless covered
with material of sufficient strength to withstand traffic loads or a method of protection approved by the Department.
DOT Form 224-030 EF Page 1 Exhibit "A"
Revised 1/2000
SPECIAL PROVISIONS FOR PERMITS AND FRANCHISES
X37. In lieu of a surety bond to ensure compliance with the terms and conditions of this document the
City of Edmonds agrees that the Department may effect reimbursement of the amount necessary
to restore the highway from the monthly fuel tax allotments which the City is normally entitled to
receive from the Motor Vehicle Fund, and in accordance with RCW 47.08.090.
X38. This permit does not give the Utility, or any agent or contractor of the Utility any rights to cut,
spray, retard, remove, destroy, disfigure or in any way modify the physical condition of any
vegetative material located on the highway right of way, except by written permission from the
department. All restoration shall be done to the satisfaction of the department at sole expense of
the utility.
X39. Regardless of any previous reviews by the Department, the Grantee shall be responsible for
acquiring any and all necessary environmental and regulatory permits as required by the
governing regulatory agency.
X40. The Utility shall be required to maintain traffic at all times, no lanes or ramps shall be allowed
closed without written Department approval and a Department approved traffic control plan.
EXHIBIT "A" PAGE 3 Utility Franchise #5104 Renewal
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