MCGAUGH_Row_permit_application. _ it i- 'EL1,i.7 n .
ROW PERMIT NO.: ENG
ISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: MCGAUGH NEW GARAGE
CONTRACTOR:RICHARD G.C.
Mailing Address: 18557 NE 116TH ST REDMOND WA 98052
State License #: RICHAGC814BT
City Business License #:
CONTACT: JORGE GUZMAN
Phone #: 206-484-2590
Fax #:
Email #: jorgelimberg@gmail.com
® Liability Insurance ® Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 880 SOMERSET LN EDMONDS WA 98020
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
❑ Commercial ❑ Subdivision ❑ City Project ❑ Traffic Control (Only)
❑ Multi -Family ® Single Family
❑ EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit?
ANY ASSOCIATED PERMITS?
❑ Other
❑ Yes ❑ No
BLD# ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific) : NEW ASPHALT APRON TO
CONNECT TO CONCRETE DRIVEWAY FOR PROPOSED GARAGE ACCESS.
CONCRETE DRIVEWAY TO TRANSITION TO ASPHALT AT PROPERTY LINE ALONG 9TH AVE N
DRIVEWAY TO BE 24FT WIDTH MAX
WAS STREET OVERLAYED WITHIN THE LAST FIVE (5) YEARS? YES ❑ NO ❑ Year:
PAVEMENT CUT: ❑ Yes V No If yes, indicate size of cut: X.
CONCRETE CUT: ❑ Yes ® No If yes, indicate size of cut: X.
RIGHT-OF-WAY
AREA
CLOSURE
I
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 RICHARD G.C. DATE 05/12/2021
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE