ENG2021-0338 ROW PERMIT APPLICATIONRIGHT OF WAY CONSTRUCTION
PERMIT APPLICATION
Complete and submit this Application in accordance with the Submittal
Requirements outlined in Right -of -Way permit Handout E6�.
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
General•
Project Name 55044204-440
Site Address or if no site address use Property Address at NW corner of project area: 7315 212th St SW Edmonds, WA 98026
Associated Permits: BLD PLN ENG
Owner and Entity Holding Franchise (if applicable)
Name of Company Franchise Ordinance No:
Point of Contact
Title
Address
City
State
Zip
Phone
Email
Contractor and Authorized Agent of Owner
Name of Company
(see note below)
Contractor Contacts During Construction
Primary Name
Agent Name
Title
Title
Mobile
Address
Email
City State
Zip
Secondary Name
Phone
Title
Email
Mobile
City of Edmonds Business License No:
Email
State License No:
Of
Contractor verifies it is currently bonded
V Contractor verifies it currently has general liability insurance
NOTE: ECDC 18.6o. o2o requires that the Application be signed by a licensed and bonded contractor unless otherwise approved by the city
engineer.
❑ Multifamily residential ❑ Commercial ❑ City project
❑ Single family residential subdivision ❑ Single family -other ❑ Industrial
❑ Demo and rebuild or from vacant land?
❑ Other, please specify:
❑ Utility Franchise Work associated with development (check one of the above boxes as welt
❑ Traffic Control Only (no associated development)
• Utility Franchise Work (no associated development)
City of Edmonds ROW construction permit Application --Page i of 3 Updated 3/25/2021
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.)
Telecommunications and broadband provider Ziply Fiber totest fiber at a man hole on 212th st SW. There
will be splicing of existing fiber on 212th st SW. There will also be a man hole access on the same east bound road of
212th st SW. This will close down the east bound right lane. Infrastructure that will be impacted will be the fiber in the
man holes. This is maintenance and putting in a new utility.
RIGHT-OF-WAY
CLOSURE
AREA
TOTAL
DURATION
(Number of Months)
Sidewalk 72 hours +
LF
I x
LF
SF
none
Alley 72 hours +
LF
Ix
I LF
SF
none
Parking 72 hours +
LF
Ix
I LF
SF
none
SECTION B - If you are not a utility company performing work in the City ROW, skip to SECTIONC.
1. The work in the right of way is on or for the following type of facilities:
VZtelecommunications ❑ cable ❑ power ❑ gas
❑ water ❑ sewer ❑ storm
Details of • to be Completed
1. Does the utility owner have existing overhead infrastructure in the area of work?
Yes
x
No
2. Will any equipment be added underground or above ground (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
4.
Does the work involve rebuilding or relocating an existing aboveground utility system which
connects a lot or commercial development to an existing underground common utility stem?
x
5.
Does the work involve proposed additions to an aboveground utility stem? 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
of • to be Completed
Yes
No
6.
Does your project involve rebuilding or replacing utility equipment which currently serves more
than one lot or commercial development?
x
If yes, answer the following questions related to project area, i.e. the actual area in which the
project is proposed:
6a.
Does your project involve wires/cables/lines? If yes:
x
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:
x
How many poles are existing in the project area?
What is the height of the existing poles?
How many poles are to be removed?
Are additional poles to be laced?
How many? I I What is the height of the additionalpoles?
6c.
Are any poles to be modified/rebuilt/replaced? If yes:
x
How many? I I 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 WAC 296-155-305 and must have
certification verifying completion of the required training in their possession.
Restoration. Restoration shall 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.
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:
APPLICANT PRINTED NAME:
APPLICANT TITLE:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
City of Edmonds ROW construction permit Application --Page 3 of 3 Updated 3/25/2021
0 06.2008 7FOAOAC 2422.201
I CERTFY TNAT THE WORK I COMPLETD ON THIS WORK ORDER
AND AS -BUILT IS IN COMPLIANCE WITH FRONTIER QUALITY
STANDARDS AS IDENTIFIED ON THE IPQIP CHECKLIST.
2408'
Xo,1R 36+ 7315 212TH ST SW, STE 104 W
HLLKWAXX F7304,61-72 HLLKWAXX 915074
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ORDER # PSR 3394119
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0 2411.001 POLES 0 2422.201 UG FIBER
_____ —_—_
212TH ST 0 --
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POINT OF CONTACT
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SITE CONTACT: MATT STEWART
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SCHEDULING: JOHNOHN WOOD
PHONE 425-261-1612
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ENGINEER: MIKE HAKAHAN
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HLLKWAXX FT157,25-28+ XD,1-4+
PHONE: 425-949-0230
FACILITIES: SHAWNCONKLIN
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PHONE: 425-263-4010
FIELDED BY: N/A
HLLKWAXX FT157,31-60+ XD,7-24
HLLKWAXX FT304,61-72+
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iHLLKWAXX FT157,73-96
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HLLK 100 MEG INTEGRATED
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REHABILITATION 7315 212TH ST SW
I
PROJECT 5504204-440 C.O. AREA'. 962
NUMBER. EXCH. CODE: 51419
DRAWN DATE:
ENGR: M. HAKAHAN
NTY: SNOHOMISH
8111/21
I PHONE: 425-949-0230
FILE:
ATCO COMMUNICATIONS SERVICES, LLC AS THE DESIGNER OF THIS TRAFFIC CONTROL PLAN,
MAKES NO REPRESENTATION AS TO ITS' GENERAL ADEQUACY OR BEING APPROVED FOR IMPLEMENTATION.
APPROVAL MUST RESULT FROM THE TRAFFIC ENGINEER OR OTHER PUBLIC OFFICIAL HAVING STATUTORY
ENFORCEMENT AUTHORITY IN THE JURISDICTION. UTILIZATION AND IMPLEMENTATION OF THIS PLAN
SHALL BE A RESULT OF THE APPROVAL. REF. MUTCD 2009 6A - 01 (10)
MM
N
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ATCO COMMUNICATIONS SERVICES, LLC
www.atcotelecom.com
360.563.9000
708 First Street
Snohomish, WA 98290
WSTCS# 012911
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DATE:
8.19.2021
DESIGNED BY.
S. UNGERECHI
ATCO CONTACT: 206.516.9038
stephen.ungerecht@atcotelecom.com
SCALE:
NOT TO
SCALE
SHEET:
01
NO: 1 OF 5
72ND A VE W
(25 MPH)
72ND A VE W
(25 MPH)
ATCO COMMUNICATIONS SERVICES, LLC AS THE DESIGNER OF THIS TRAFFIC CONTROL PLAN,
MAKES NO REPRESENTATION AS TO ITS' GENERAL ADEQUACY OR BEING APPROVED FOR IMPLEMENTATION.
APPROVAL MUST RESULT FROM THE TRAFFIC ENGINEER OR OTHER PUBLIC OFFICIAL HAVING STATUTORY
ENFORCEMENT AUTHORITY IN THE JURISDICTION. UTILIZATION AND IMPLEMENTATION OF THIS PLAN
SHALL BE A RESULT OF THE APPROVAL. REF. MUTCD 2009 6A - 01 (10)
WORK DETAILS:
SET UP MANHOLE
w SPOTTER NEEDED FOR PEDESTRIAN s
TRAFFIC AND DRIVEWAY ACCESS.
250'
WORK
BUFFER SPA
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WARNING SIGN
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(ASS NNMM)
BUFFER AREA
LONGITUDINAL BUFFER SPACE = B
POSTED SPEED (MPH)
25
30 35 40
45
50
55
60
64
70
LENGTH (feet)
155
200 1 250 305
360
425
495
570
645
730
TRANSPORTABLE ATTENUATOR ROLL AHEAD DEVICE = R
HOST VEHICLE WEIGHT (Ibs)
9,900 TO 22,000
HOST VEHICLE WEIGHT (Ibs)
> 22,000
< 45 MPH
45 - 55 MPH
> 55 MPH
< 45 MPH
45 - 55 MPH
> 55 MPH
100,
123'
172'
74'
100,
150'
NOTE:
MON. - FRI. = 7:00am TO 4:00pm
PHASE 1-
ATCO COMMUNICATIONS SERVICES, LLC
www.atcotelecom.com
360.563.9000
708 First Street
Snohomish, WA 98290
WSTCS# 012911
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W20-1 W4-2L W20-5R
CHANNELIZATION DEVICE
SPACING (feet)
MPH
TAPER
TANGENT
50/70
40
80
35/45
30
60
25/30
20
40
MINIMUM LANE CLOSURE TAPER LENGTH = L (feet)
LANE
POSTED SPEED (MPH)
WIDTH
(feet)
25
30
35
40
45
50
55
60
65
70
10
105
150
205
270
450
500
550
600
650
700
11
115
165
225
295
495
550
605
660
715
770
12
125
180
245
320
540
600
660
720
780
840
SIGN SPACING = X (1)
FREEWAY & EXPRESSWAYS 55 / 70 MPH
1500' ±
RURAL HIGHWAYS 60 / 65 MPH
800' ±
RURAL ROADS 45 / 55 MPH
500' ±
RURAL ROADS & URBAN ARTERIALS 35 / 40 MPH
350' ±
RURAL ROADS & URBAN ARTERIALS 25 / 30 MPH
RESIDENTIAL & BUSINESS DISTRICTS
200' ± (2)
URBAN STREETS 25 MPH OR LESS
100'± (2)
(1) ALL SPACING MAY BE ADJUSTED TO ACCOMMODATE INTERCHANGE RAMPS,
AT -GRADE INTERSECTIONS AND DRIVEWAYS
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DESIGNED BY: S. UNGERECHI
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stephen.ungerecht@atcotelecom.com
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NO: 2OF5
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ATCO COMMUNICATIONS SERVICES, LLC AS THE DESIGNER OF THIS TRAFFIC CONTROL PLAN,
MAKES NO REPRESENTATION AS TO ITS' GENERAL ADEQUACY OR BEING APPROVED FOR IMPLEMENTATION,
APPROVAL MUST RESULT FROM THE TRAFFIC ENGINEER OR OTHER PUBLIC OFFICIAL HAVING STATUTORY
ENFORCEMENT AUTHORITY IN THE JURISDICTION. UTILIZATION AND IMPLEMENTATION OF THIS PLAN
SHALL BE A RESULT OF THE APPROVAL. REF. MUTCD 2009 6A - 01 (10)
BUFFER AREA
LONGITUDINAL BUFFER SPACE = B
POSTED SPEED (MPH)
25
30 35 40
45
50
55
60
64
70
LENGTH (feet)
155
200 1 250 305
360
425
495
570
645
730
TRANSPORTABLE ATTENUATOR ROLL AHEAD DEVICE = R
HOST VEHICLE WEIGHT (Ibs)
9,900 TO 22,000
HOST VEHICLE WEIGHT (Ibs)
> 22,000
< 45 MPH
45 - 55 MPH
> 55 MPH
< 45 MPH
45 - 55 MPH
> 55 MPH
100,
123'
172'
74'
100,
150'
NOTE:
MON. - FRI. = 7:00am TO 4:00pm
CHANNELIZATION DEVICE
SPACING (feet)
MPH
TAPER
TANGENT
50/70
40
80
35/45
30
60
25/30
20
40
MINIMUM LANE CLOSURE TAPER LENGTH = L (feet)
LANE
POSTED SPEED (MPH)
WIDTH
(feet)
25
30
35
40
45
50
55
60
65
70
10
105
150
205
270
450
500
550
600
650
700
11
115
165
225
295
495
550
605
660
715
770
12
125
180
245
320
540
600
660
720
780
840
PHASE 1
WORK DETAILS:
0 TEST FIBER FROM EXISTING MP❑E
w SPOTTER NEEDED FOR PEDESTRIAN
TRAFFIC AND DRIVEWAY ACCESS.
N
6
SIGN LEGEND:
ROAD RIGHT LANE
< > <* WORK CLOSED
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W20-1 W4-2L W20-5R
LEGEND:
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TYPE III BARRICADE
WORK TRUCK
WORK ZONE LIMITS
MUM
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(ASGGER
NEEDED)
SIGN SPACING = X (1)
FREEWAY & EXPRESSWAYS 55 / 70 MPH
1500' ±
RURAL HIGHWAYS 60 / 65 MPH
800' ±
RURAL ROADS 45 / 55 MPH
500' ±
RURAL ROADS & URBAN ARTERIALS 35 / 40 MPH
350' ±
RURAL ROADS & URBAN ARTERIALS 25 / 30 MPH
RESIDENTIAL & BUSINESS DISTRICTS
200' ± (2)
URBAN STREETS 25 MPH OR LESS
100'± (2)
(1) ALL SPACING MAY BE ADJUSTED TO ACCOMMODATE INTERCHANGE RAMPS,
AT -GRADE INTERSECTIONS AND DRIVEWAYS
(2) THIS SPACE MAY BE REDUCED IN URBAN AREAS TO FIT ROADWAY CONDITIONS.
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www.atcotelecom.com
360.563.9000
708 First Street
Snohomish, WA 98290
WSTCS# 012911
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DESIGNED BY: S. UNGERECHI
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stephen.ungerecht@atcotelecom.com
SCALE: SHEET-
1 40: 03
NO: 3OF5
SIGN LEGEND:
ROAD
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CLOSED CLOSED
AHEAD
W20-1
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❑PERATI❑NS OR FACILITIES: CONTACT
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PR❑VIDE ONE WEEK N❑TIFICATI❑N FOR
BUS STOP IMPACTS
ATCO COMMUNICATIONS SERVICES, LLC AS THE DESIGNER OF THIS TRAFFIC CONTROL PLAN,
MAKES NO REPRESENTATION AS TO ITS' GENERAL ADEQUACY OR BEING APPROVED FOR IMPLEMENTATION.
APPROVAL MUST RESULT FROM THE TRAFFIC ENGINEER OR OTHER PUBLIC OFFICIAL HAVING STATUTORY
ENFORCEMENT AUTHORITY IN THE JURISDICTION. UTILIZATION AND IMPLEMENTATION OF THIS PLAN
SHALL BE A RESULT OF THE APPROVAL. REF. MUTCD 2009 6A - 01 (10)
BUFFER AREA
LONGITUDINAL BUFFER SPACE = B
POSTED SPEED (MPH)
25
30 35 40
45
50
55
60
64
70
LENGTH (feet)
155
200 1 250 305
360
425
495
570
645
730
TRANSPORTABLE ATTENUATOR ROLL AHEAD DEVICE = R
HOST VEHICLE WEIGHT (Ibs)
9,900 TO 22,000
HOST VEHICLE WEIGHT (Ibs)
> 22,000
< 45 MPH
45 - 55 MPH
> 55 MPH
< 45 MPH
45 - 55 MPH
> 55 MPH
100,
123'
172'
74'
100,
150'
NOTE:
MON. - FRI. = 7:00am TO 4:00pm
N
PHASE 2 b
250'
BUFFER SPA
DRIv
M
CHANNELIZATION DEVICE
SPACING (feet)
MPH
TAPER
TANGENT
50/70
40
80
35/45
30
60
25/30
20
40
MINIMUM LANE CLOSURE TAPER LENGTH = L (feet)
LANE
POSTED SPEED (MPH)
WIDTH
(feet)
25
30
35
40
45
50
55
60
65
70
10
105
150
205
270
450
500
550
600
650
700
11
115
165
225
295
495
550
605
660
715
770
12
125
180
245
320
540
600
660
720
780
840
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800' ±
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500' ±
RURAL ROADS & URBAN ARTERIALS 35 / 40 MPH
350' ±
RURAL ROADS & URBAN ARTERIALS 25 / 30 MPH
RESIDENTIAL & BUSINESS DISTRICTS
200' ± (2)
URBAN STREETS 25 MPH OR LESS
100'± (2)
(1) ALL SPACING MAY BE ADJUSTED TO ACCOMMODATE INTERCHANGE RAMPS,
AT -GRADE INTERSECTIONS AND DRIVEWAYS
(2) THIS SPACE MAY BE REDUCED IN URBAN AREAS TO FIT ROADWAY CONDITIONS.
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DESIGNED BY: S. UNGERECHI
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SCALE: SHEET-
1 4 0: 04
NO: 4OF5
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SIGN LEGEND: PHASE 2
ROAD RIGHT LAN> <( < E CENTER LANE ATCO COMMUNICATIONS SERVICES, LOLC
WORK CLOSED CLOSED www.atcotelecom.com
AHEAD AHEAD AHEAD WORK DETAILS: 360.563.9000
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Snohomish, WA 98290
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SP❑TTER NEEDED F❑R PEDESTRIAN
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W ANY WORK AFFECTING TRANSIT
225' OPERATIONS OR FACILITIESi CONTACT
W 350' 350' 350' CIC @ 206-477-1140
MERGING TAPER (L) PR❑VIDE ONE WEEK N❑TIFICATI❑N FOR 3
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ATCO COMMUNICATIONS SERVICES, LLC AS THE DESIGNER OF THIS TRAFFIC CONTROL PLAN,
C\Q �- MAKES NO REPRESENTATION AS TO ITS' GENERAL ADEQUACY OR BEING APPROVED FOR IMPLEMENTATION. VIM ZONE UMrM Z < Iyj
W20-1 APPROVAL MUST RESULT FROM THE TRAFFIC ENGINEER OR OTHER PUBLIC OFFICIAL HAVING STATUTORY YyARNMID SIGN 0 Q Q
ENFORCEMENT AUTHORITY IN THE JURISDICTION. UTILIZATION AND IMPLEMENTATION OF THIS PLAN Q Z
U SHALL BE A RESULT OF THE APPROVAL. REF. MUTCD 2009 6A - 01 (10) BOARD
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DATE: &16.2021
NOTE:
MON. - FRI. = 7:00am TO 4:00pm-2::ATCO CONTACT: 206.516.9038
stephen.ungerechtC�atcotelecom.com
SCALE: SHEET-
WIDTH
1)= 40� Ob
NO: 5OF5
DESIGNED BY: S. UNGERECHI
FREEWAY &EXPRESSWAYS 55 / 70 MPH 1500' ±
RURAL HIGHWAYS 60 / 65 MPH 800' ±
RURAL ROADS 45 / 55 MPH 500' ±
RURAL ROADS &URBAN ARTERIALS 35 / 40 MPH 350' ±
RURAL ROADS &URBAN ARTERIALS 25 / 30 MPH 200' ± (2)
RESIDENTIAL &BUSINESS DISTRICTS
BUFFER AREA
LONGITUDINAL BUFFER SPACE = B
POSTED SPEED (MPH)
25
30 35 40
45
50
55
60
64
70
LENGTH (feet)
155
200 250 305
360
425
495
570
645
730
TRANSPORTABLE ATTENUATOR ROLL AHEAD DEVICE = R
9,900 TO 22,000
> 22,000
< 45 MPH
45 - 55 MPH
> 55 MPH
< 45 MPH
45 - 55 MPH
> 55 MPH
CHANNELIZATION DEVICE
SPACING (feet)
MPH
TAPER
TANGENT
50/70
40
80
35/45
30
60
5/30
20
40
MINIMUM LANE CLOSURE TAPER LENGTH = L (feet)
LANE
POSTED SPEED (MPH)
WIDTH
(feet)
25
30
35
40
45
50
55
60
65
70
10
105
150
205
270
450
500
550
600
650
700
11
115
165
225
295
495
550
605
660
715
770
SIGN SPACING = X (1)
URBAN STREETS 25 MPH OR LESS 100'± (2)
(1) ALL SPACING MAY BE ADJUSTED TO ACCOMMODATE INTERCHANGE RAMPS,
AT -GRADE INTERSECTIONS AND DRIVEWAYS
(2) THIS SPACE MAY BE REDUCED IN URBAN AREAS TO FIT ROADWAY CONDITIONS.