ENG2023-0012 ROW PERMIToff' EIDM
OF WAY EUC PERMIT
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City of Edmonds PERMIT NUMRIGHT
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Edmonds98020 1 11
www.edmondswa.gov i
Description: ZIPLY - TRANSFER FIBER TO NEW POLE AND REMOVE BO POLE
ISSUED: 02/09/2023
Address: 19221 88TH AVE W EDMONDS WA 98026-6112
EXPIRES:08/09/2023
Permit Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 27041800308800
CONTACTS
NAME TYPE NAME ADDRESS PHONE
APPLICANT ARIANNE MOMMSEN 1800 41ST ST STE N-100, EVERETT WA 98230 (402)670-8384
CONTACT ZIPLY FIBER 1800 41ST STREET STE N-100, EVERETT WA 98230 (830)513-6614
CONTRACTOR ZIPLY FIBER 1800 41ST ST, EVERETT WA 98201 (425)949-0230
OWNER LISA A & RYAN KEVIN D GARBERSON 19221 88TH AVE W, EDMONDS WA 98026-6112
FEE INFORMATION
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE CHARGED PER PERMIT $40.00 $40.00
ENGINEERING INSPECTION FEE $110.00 $110.00
RIGHT OF WAY STANDARD - EUC PERMIT FEE $330.00 $330.00
REQUIREMENTS
REQUIREMENT TYPE NOTES
TRAFFIC CONTROL
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 posession.
RESTORATION
Restoration is to be in accordance with City codes. All street -cut trench work shall be patched with
asphalt or City approved material prior to the end of the workday - No Exceptions
WARRANTY The contractor is responsible for workmanship and materials for a period of one year following the final
inspection and acceptance of the work.
INSPECTION SCHEDULING: WWW.MYBUILDING PERMIT.COM
24 HR NOTICE REQUIRED
INDEMNITY
The Applicant has signed an application which states he/she holds 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 but not limited to the defense of any legal proceedings including defense costs and attorney
fees by reason of granting this permit.
RELEASED BY: MAJ DATE: 02/09/2023
Printed: Thursday, February 09, 2023 12:39:54 PM 1 of 2
RIGHT PERMIT
PERMIT NUM
City of Edmonds
Edmonds WA 98020
www.edmondswa.gov / 425.1 1
CONDITIONS
CONDITION TYPE
NOTES
ALERT RESIDENTS
ALERT AFFECTED RESIDENTS AND OR BUSINESSES PRIOR TO WORK START.
It is the owner's responsibility to repair/replace all damage of utilities or frontage improvements in
DAMAGE TO FRONTAGE
City right of Ways or Easements to City Standards caused by or occurring during the permitted
IMPROVEMENTS
project.
MAINTAIN EROSION AND SEDIMENTATION CONTROL PER CITY AND SWMMW STANDARD
ESC REQUIREMENTS
REQUIREMENTS.
Applicant, on behalf of his or her spouse, heirs, assigns, and successors in interests, agrees to
indemnify defend and hold harmless the City of Edmonds, Washington, its officials, employees, and
agents from any and all claims for damages of whatever nature, arising directly or indirectly from the
HOLD HARMLESS
issuance for this permit. Issuance of this permit shall not be deemed to modify, waive or reduce any
requirements of any City ordinance nor limit in any way the City's ability to enforce any ordinance
provision.
SCHEDULE REQUIRED INSPECTIONS AS NOTED THROUGH MY BUILDING PERMIT.
INSPECTIONS
www.mybuildingpermit.com
POTHOLING
VERIFY CLEAR BORE CROSSINGS.
RESTORE LANDSCAPE
Restore landscape to like or better conditions
Sound or noise originating from temporary construction sites as a result of construction activity are
exempt from the noise limits of ECC Chapter 5.30 only during the hours of 7:00am to 6:00pm on
SOUND AND NOISE
weekdays and 10:00am and 6:00pm on Saturdays, excluding Sundays and Federal Holidays. At all
other times the noise originating from construction sites and activities must comply with the noise
limits of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120.
All utilities shall be located prior to any excavation. New locates shall be called for if at time of
UTILITY LOCATES
excavation, original locates are no longer identifiable.
INSPECTIONS
INSPECTION TYPE
DATE
RESULT
NOTES
COMPLETE
A-1 JOB START
E-7 TRAFFIC CTRL
X-2 ENGINEERING FINAL"
Printed: Thursday, February 09, 2023 12:39:54 PM 2 of 2
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SECTION A
RIGHT OF WAY CONSTRUCTION
PERMIT APPLICATION
Complete and submit this Application in accordance with the Submittal
Requirements outlined in Right -of -Way permit Handout E63.
RECEIVED
Jan 09 2023
CITY OF EDMONDS
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.
General Info
Project Name 5511605-425
Site Address or if no site address use Property Address at NW corner of project area: • g A VV 111 A/
Associated Permits: BLD PLN ENG
Owner and Entity Holding
Name of Company Ziply Fiber Northwest, LLC Franchise Ordinance No: WN U-17
Point of Contact Mike Hakahan
Title Engineer
Address1800 41 st St., Ste. N 100
city Everett
State WA
zip 98203
Phone 425-949-0230
Email mike.hakahan@ziply.com
Contractor and Authorized Agent of Owner (see note below)
Name of Company Ziply Fiber Northwest, LLC
Contractor Contacts During Construction
Primary Name Mike Hakahan
Agent Name Mike Hakahan
Title Engineer
Title Engineer
Mobile 425-949-0230
Address1800 41st St. Ste. N100
Email mike.hakahan@ziply.com
City Everett
I state WA
zip 98203
Secondary Name
Phone 425-949-0230
Title
Email mike.hakahan@ziply.com
Mobile
City of Edmonds Business License No: 313-013-420
Email
state License No: ZIPLY*80OL5
0 Contractor verifies it is currently bonded
Contractor verifies it currently has general liability insurance
NUTS: 1 CDC 18.60.020 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 well)
❑ Traffic Control Only (no associated development)
City of Edmonds ROW construction permit Application --Page 1 of 3 Updated 3/25/2021
m Utility Franchise Work (no associated development)
Project Description
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 & broadband provider Ziply Fiber to transfer attachments. PUD to place new pole and remove existing pole.
RIGHT-OF-WAY
CLOSURE
AREA
TOTAL
DURATION
(Number of Months)
Sidewalk 72 hours +
LF
JxJ
LF
SF
Alley 72 hours +
LF
JxJ
F
SF
Parking 72 hours +
LF
JxJ
LF
SF
SECTION B - If you are not a utility company performing work in the City ROW, skip to SECTION C.
1. The work in the right of way is on or for the following type of facilities:
* telecommunications ❑ cable ❑ power ❑ gas
❑ water ❑ sewer ❑ storm
1.
CompletedDetails of Work to be
Does the utility owner have existin overhead infrastructure in the area of work?
•
X
2.
Will any equipment be added underground or above ground (e.g. 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 system?
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 of • to be Completed
®i
6. Does your project involve rebuilding or replacing utility equipment which currently serves more
X
than one lot or commercial development?
City of Edmonds ROW construction permit Application --Page 2 of 3 Updated 3/25/2021
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? 1 1 1 How many are to be added? o
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? What is the height of the poles after?
Describe the modification rebuild: 0 ly 0 d in 0 0
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: DATE:
APPLICANT PRINTED NAME: M N
APPLICANT TITLE: FJ
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
City of Edmonds ROW construction permit Application --Page 3 of 3 Updated 3/25/2021
- •" ,..�r�n yr UTILITIES, REMOVAL OF POLE AND FINAL RESTORATION TO BE CONSISTENT
POLE pL I �a �` — WITH APPLICABLE POLE ATTACHME]�TT AGREEMENT(S) AND JOINT OWNERSHIP P
SET 80' CL H2 IROSTENCIL E71GHT/FggrW PLI
SET DEPTH = 10 '—----_OLEAGREEMENT,
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101 To CATV: New C'ingular ZIPLY Exchange
XFR OH
____ Ln' w ZIPLY COMCAST 210D Date
XFR FIBER (J101) — —~ o a Customer Name Service Address 7/28/22
TIE SVC TO z o ^ SNOPUD Emergency pole Replacement
NEUT FOR NESC CLEARANCE (R1041 a ,'_ N PUD ORDER/OPERATION No, 19221 88TH AVE W. EDMONDS
STRIP enin T,,.. & R1D471 in 100085553 / 0030 PUD Engineer
ALEX CHORPUD Approved
PUD INTENDS 10 PERFORM THE FOLLOWINEY 425_418_8i71
G ON THIS WORK ORDER:
❑ Set Poles Out —
® Replace 1 Poles ❑ Set Additional 8" Helix Anchors
Poles From PUD System
❑ Eliminate ❑ Set Additional 12" Helix Anchors In
❑ Customer Pay 100% Contacts Free To ZIPLY
❑ PUD To Contact ZIPLY Pole(s) At Location(s) �
Other
BM Number
ZIPLY Pay 45Y Of The Following (Estimates Only) PUD Work
Easement Estimate _ Completed
PUD is abandoning its use of each pole ZIPLY Transfer a CATV Transfer Y�
designated to be replaced or eliminated
hereunder and is removing its attachments therefrom
Ziply rental on] . W 0 G�•c9 q y �
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Additional Anchors At The Following Locotinn z
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'ost Pole/Locotion
Reference v, a
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❑NO JOINT USE
WO/USOA Codes
�j Approved By -
Size Recovery
(Size/Year) Cost
Date:
LEGEND:
EXISTING UTILITY POLE
® PROPOSED NEW POLE
WORK DETAILS:
PUD WILL PLACE NEW POLE, ZIPLY TO
TRANSFER ATTACHMENT THEN REMOVE
EXISTING POLE.
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RECEIVED
Jan 09 2023
CITY OF EDMONDS
DEVELOPMENT SERVICES
DEPARTMENT
ziPylfiber
Everett, WA 98206
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DATE: 12.28.2022
DESIGNED BY: R.MERAZ
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RECEIVED
Jan 09 2023
CITY OF EDMONDS
DEVELOPMENT SERVICES
DEPARTMENT
DEVELOPMENT SERVICES
DEPARTMENT
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LEGEND:
SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM
OSIGNALIZED
INTERSECTION
OCONE
(CANDLESTICK)
®
TYPE III BARRICADE
WORK TRUCK
WORK ZONE LIMITS
WARNING SIGN
ARROW BOARD
E
(WHERE REQUIRED)
DIRECTION OF TRAFFIC
(NOT PAVEMENT MARKINGS)
FLAGGER
(AS NEEDED)
88TH AVE W
D/W I (25 MPH)
—
W20-1
W20-4
SIGN LEGEND:
ROAD ONE LANE
WORK ROAD
AHEAD AHEAD
W20-1 W20-4 W20-7A
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)
W20-7A
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
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'
50'-100'
ONE
LANE,
TWO WAY
TRAFFIC
TAPER
10' MIN. '1
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O p O
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RIVEWAY D/W
50'-100' WORK )
ONE AREA
LANE,
TWO WAY
TRAFFIC
TAPER
TRAFFIC CONTROL INSPECTION SHALL BE
REQUIRED WHENEVER WORK ZONE IS SET UP
NOTE:
MON. - FRI. = 7:00am TO 4:00pm
PHASE 1 & Z
192ND ST SW
(25 MPH)
W20—
W20-7
ENGINEERING DIVISION
APPROVED AS NOTED
Ildl j#Lj0,04. 02/06/2023
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CHANNELIZATION DEVICE
SPACING (feet)
MPH TAPER
TANGENT
50/70 40
80
35/45 30
60
25/30 20
40
MINIMUM SHOULDER TAPER LENGTH = L/3 (feet)
SHOULDER
POSTED SPEED (MPH)
WIDTH
(feet)
25
30
35
40
45
50
55
60
65
70
8
40
40
60
90
120
130
150
160
170
190
10
40
60
90
90
150
170
190
220
220
240
USE A MINIMUM 3 DEVICES TAPER FOR SHOULDER LESS THAN 8'
� 41
W20-4
RECEIVED
Jan 09 2023
CITY OF EDMONDS
DEVELOPMENT SERVICES
DEPARTMENT
WORK DETAILS
Qt PLACE NEW POLE, TRANSFER
ATTACHMENTS THEN REMOVE
EXISTING P❑LE,
SPOTTER NEEDED FOR PEDESTRIAN
TRAFFIC AND DRIVEWAY ACCESS,
SIGN SPACING = X (1)
FREEWAY & EXPRESSWAYS 55/70MPH
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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ATCO COMMWNICATIONSSERVICES. LLC
www.atcotelecom.com
360.563.9000
708 First Street
Snohomish, WA 98290
zipyEIfiber
verett, WA 98206
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DATE: 01.04.2023
REVIEWED BY: D. LAFLEUR
WSTCS# 013259
DESIGNED BY: L. MATEO
ATCO CONTACT: 916.202.7699
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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)
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Jan 09 2023
CITY OF EDMONDS
DEVELOPMENT SERVICES
DEPARTMENT
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www.atcotelecom.com
360.563.9000
708 First Street
Snohomish, WA 98290
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Everett, WA 98206
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DATE:
01.04.2023
REVIEWED BY:
D. LAFLEUR
WSTCS# 013259
DESIGNED BY:
L. MATEO
ATCO CONTACT:
916.202.7699
lance.mateo@atcotelecom.COm
SCALE:
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RECEIVED
Jan 09 2023
CITY OF EDMONDS CITY OF EDMONDS
DEVELOPMENT SERVICES
DEPARTMENT
Right -of -Way Application #1250594 - 5511605-425
MyBuildingPermit.com
Applicant
First Name Last Name Company Name
Arianne Mommsen Ziply Fiber
Number Street Apartment or Suite Number E-mail Address
1800 41st St Ste N-100 arianne.mommsen@ziply.com
City State Zip Phone Number Extension
Everett WA 98230 (402) 670-8384
Contractor
Company Name
Contractor Unknown
Number Street Apartment or Suite Number
City State Zip Phone Number Extension
State License Number License Expiration Date UBI # E-mail Address
Project Location
Number Street Floor Number Suite or Room Number
19221 88TH AVE W
City Zip Code County Parcel Number
EDMONDS 98026 27041800308800
Associated Building Permit Number Tenant Name
Additional Information (i.e. equipment location or special instructions)_
Work Location
Property Owner
First Name Last Name or Company Name
Lisa A & Ryan Kevin D Garberson
Number Street Apartment or Suite Number
19221 88TH AVE W
City State Zip
EDMONDS WA 98026-6112
Certification Statement - The applicant states:
I certify that I am the owner of this property or the owner's authorized agent. If acting as an authorized agent, I further certify that I have full power and
authority to file this application and to perform, on behalf of the owner, all acts required to enable the jurisdiction to process and review such application. I
have furnished true and correct information. I will comply with all provisions of law and ordinance governing this type of application. If the scope of work
requires a licensed contractor to perform the work, the information will be provided prior to permit issuance.
Date Submitted: 1/6/2023 Submitted By: Arianne Mommsen
Page 1 of 2
CITY OF EDMONDS MyBuildingPermit.com
Right -of -Way Application #1250594 - 5511605-425
Project Contact
Company Name: Ziply Fiber
Name: Victoria Comer Email: victoria.comer@Ziply.com
Address: 1800 41 st Street Ste N-100 Phone #: (830) 513-6614
Everett WA 98230
Project Type Activity Type Scope of Work
Utility Purveyor Utility Work Disturbance of Surface
Project Name: 5511605-425
Description of Work: Place new pole, transfer attachments then remove existing pole
Project Details
Project Information
Job Number
5511605-425
Page 2 of 2