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ENG2021-0293-ROW PERMIT APPLICATION-07.29.2021E N G2021-0293 L��t t7F tD�tp�r RECEIVED RIGHT OF WAY CONSTRUCTION J U L 29 2021 PERMIT APPLICATION Complete and submit this Application in accordance with the Submittal CITY OF EDMONDS 10o 0 Requirements outlined in Right -of -Way permit Handout E61. DEVELOPMENT SERVICES DEPARTMENT If any field is not applicable to your project, write "N/A" instead of leaving blank. All fields required. Incomplete Applications will be denied. SECTION A Proj` ` va eTalbot Road Maple Removal Site Address or if no site address use Property Address at NW corner of project area:17715 Talbot Road Associated Permits: IBLD Ply STF20210007 1ENG Name of Company Franchise Ordinance No: Point of Contact Renee Drew Title __.._..— Address 17715 Talbot Road City Edmonds — — State VVA Zip98026 Phone 206-795-5193 !;mail reneeda1@hotmail.com Con tractorand Authorized Agent of Owner Name of Company Washington Tree Experts (sec, note below) Contractor Contacts Durin, Primary NameGeno Wells g Construction AgentNarn� Jennifer Wells title Owner Mobile 206-265-0290 1]fle Owner — - Address9792 Edmonds Way #123 Email City Edmonds State WA Zig98020 secondary Name Les Yarbrough Phone425-771-4430 Title Crew Lead Email wtetree@yahoo.com Mobile 206-200-5602 City of Edmonds Business License No: Email State License No. 602997491 Contractor verifies it is currently, banded Contractor verifies it currently has general liability insurance N0Tb; ,dCDG2tf.00.ozo requires that theAppucation be signed by a licensed and bonded contractor unless otherwise approved by the city engineer. LType of 1)evelopment — Check AU, that apply c Multifamily residential ❑ Commercial a City project ❑ Single family residential subdivision . Single family -other ❑ Industrial o Demo and rebuild or from vacant land? ❑ Other, please specify: a Utility Franchise Work associated with development (check one 12f the above boxes as wel0 XTraffic Control Only (no associated development) ❑ Utility Franchise Work (no associated development) City of Edmonds ROW construction permit Application --Page 1 of 3 Updated 3/25/2021 Project Dtscription Include an overall narrative description of the proposed work. Be specific and detailed: Describe infrastructure to be impacted, such as, poles, wires, conduit, utility mains, etc. Include whether this is construction, maintenance, or repair. Include description of proposed construction methods, (e.g., bores, trenches, overhead wires proposed, depth for underground utilities, etc.) Intermittent lane closure and traffic control to safely remove tree hanging over the right of way. See attached traffic control plan. Job duration 8am-4om 6/26/2021 RIGHT-OF-VITAY CLOSURE AREA TOTAL DURATION (Number of Months) Sidewalk 72 hours + LF x LF SF Alley 72 hours + LF x LF SF Parking 72 hours + I LF x LF SF SECTION B - If you are not a utility company performing work in the City ROW, skin to SECTION C. 1. The work in the right of v,,ay is on or for the following type of facilities:: ❑ telecommunications ❑ cable © power ❑ gas ❑ water ,i server ❑ storm 1. itility owner have existing overhead infrastructure in the area of work? x 2. Will an equipment be added underground or above round e.. pedestals,vaults etc.)? x If yes, describe: : __ 3. Does the proposed work connect a lot or commercial development with utilities that serve more than one lot or commercial development? x Q. Does the work involve rebuilding or relocating an existing aboveground utility system which connects a lot or commercial develo ment to an eidstiEg underg ound common utility -stem? X 5. Does the work involve proposed additions to an aboveground utility system? If es: x Are the additions for the purpose of serving new commercial development? Are the additions for the purpose of serving a single-family residential subdivision? Details Work be Completed 6. of to Does your project involve rebuilding or replacing utility equipment which currently serves more than one lot or commercial development? If yes, answer the following questions related to project area, i.e. the actual area in which the Fo ectiS ro osed' Yes No X 6a. Does your project involve wires/cables/lines? If yes: How many are existing? I I How many are to be added? City of Edmonds ROW construction permit Application --Page 2 of 3 Updated 3/25/2021 6b. Does your project involve poles? If yes: How many poles are existing in the prrJect area? What is the height of the existing poles? How many poles are to be removed? Are additional poles to be Place& Howma. What is the height of the additionalpoles?_: 6c. Are any poles to be modified/rebuilt/replaced? If yes: How many? What is the height of the poles after? Describe the modification rebuild: SECTION C Traffic Control and Public Safety. 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 WAG 296-155-305 and must have certification verifying completion of the required training in their possession. Restoration. Restoration shall be in accordancewith 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. Insurance. The City may require the owner or contractor to provide proof of insurance acceptable to the City prior to any permit approval. Indemnification. The Applicant agrees to defend, indemnify, and hold harmless the City of Edmonds, its officials, officers, employees, and agents against any injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, including defense costs and attorney fees, resulting directly or indirectly from any act or omission of the Applicant, its subcontractors, anyone directly or indirectly employed by them, and anyone for whose acts or omissions they may be liable, arising out of, related to, or by reason of the granting of this permit; and specifically including but not limited to all loss by the failure of the Applicant to fully or adequately perform, in any respect, all authorizations or obligations under the permit. These indemnification requirements shall survive the expiration, revocation, or termination of any resulting permit approval. Acceptance of terms, conditions, and requirements. Applicant accepts the terms, conditions, and requirements set forth in this Application and agrees they apply to any resulting permit and shall comply with them to the satisfaction of the City Engineer. Applicant further agrees to comply with the conditions listed on the Submittal Requirements; with all applicable city ordinances, including but not limited to ECDC Title 18; and with all applicable requirements of state and federal law. Statement of Applicant. I declare under penalty of perjury under the laws of the State of Washington that: I am a licensed and bonded contractor; the information provided herein is correct and complete; and I am authorized by owner to act on its behalf and have authority to bind the owner to this application. Fees. The Applicant is responsible for all permit fees. APPLICANT SIGNATURE: 0�DATE: 7/29/2021 APPLICANT PRINTED NAME: AqwAr wells APPLICANT TITLE: Owner NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE City of Edmonds ROW construction permit Application --Page 3 of 3 Updated 3/25/ 2021 Drew (Edmonds) July 29, 2021 Page 1 of 3 To: Client name Street: City, Zip: Re: Washington Tree Experts 9792 Edmonds Way #123 Edmonds, WA 98020 206-362-3380 wtetree@yahoo.com City of Edmonds Engineering Division Sean and Renee Drew 17715 Talbot Rd. Edmonds, WA 98026 RECEIVED J U L 29 2021 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT Bigleaf maple (Acer mocrophyllum) = 37" diameter at standard height Site maps (not to scale for illustration purposes) N Washington Tree Experts Certified Arborist .:...;I� Drew (Edmonds) July 29, 2021 Page 2 of 3 City of Edmonds GIs Map 1142 RECEIVED J U L 29 2021 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT x -..Maq 17808 � .11� 1 is M -MIR M ON L M 0 = nuisance bigleaf maple 2-119 17709 177 5 17819 i 17839 Washington Tree Experts Certified Arborist Drew (Edmonds) July 29, 2021 Page 3 of 3 Washington Tree Experts Certified Arborist RECEIVED J U L 29 2021 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT U) � n L /� �0:� m rn m<0 r 0 rn >m0 �Z 0 CDrn \ m Z v a a0 O �d A F a LI� t ` \ N � rdb/orate O a a Notes: 1. All signs and spacing must conform to the City of Edmonds, WSDOT, and the MUTCD. 2.AI1 signs are 36'x 36" B/0 unless otherwise specified. 3.Channeling devices are 28" cones with retro reflective banding. 4. Notify City, County or WSDOT authorities 48 to 72 hours in advance of work if required. 5. Flaggers will require radios. PlansbyDonna, as the preparer of this traffic control plan makes no representation as to its general adequacy or being approved for implementation. TTC plans and devices shall be the responsibility of the authority of a public body or official (road owner) having jurisdiction for guiding road users. MUTCD 6A.01(10) N o r- O n O C-) c m �z >_z-j� �o C) 6 O D 0 O � H cn Lo z m n o� O rn Z < Z 0 M o a Z D <p y m o a J w w � -o N O In V ry mO rr g U G) a y m i A p m M 0 m Z ~ N A N N 3 p� En 01