The URL can be used to link to this page

APPROVED ENG ENG2022-0137 ROW PERMIT PACKET - LFRIGHT OF WAY CONSTRUCTION PERMIT APPLICATION Complete and submit this Application in accordance with the Submittal 'VC. 1890 Requirements outlined in Right -of -Way permit Handout E63. 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 BLD2022-0116 Samora, Mike - Retaining Wall Site Address or if no site address use Property Address at NW corner of project area: 7330 172nd st SW Edmonds WA 98026 Associated Permits: BLD PLN ENG Name of Company NA Franchise Ordinance No: NA Point of Contact NA Title NA Address NA City NA State NA Zip NA Phone NA Email NA Contractor and Authorized Agent of • • - below) Name of company Dreamscapes Landscape & Design LLC C• • • During Construction Primary Name Jacob Tate Agent Name Jacob Tate Title Owner Title Owner/Member Mobile 360.485.7532 Address 24301 7th PI W Email Ownerdreamscapes@gmail.com City Bothell State WA Zip 98021 Secondary Name Jonelle Cornwell Phone 206.494.4695 Title Admin Email Ownerdreamscapes@gmail.com Mobile206.494.4695 City of Edmonds Business License No: 602996217 City Endorsement on state license Email DreamscapesPNW@gmail.com State License No: 602996217 91 Contractor verifies it is currently bonded Contractor verifies it currently has general liability insurance NOTE: ECDC 18.6o.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? \.,6 Other, please specify: Retaining Wall apprx 240 sq ft ❑ 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 ❑ 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.) Removal of old wall, materials will be taken off site Install Manorstone retaining wall with caps, 3-4 feet in hieght, apprx 240 sq ft total Install landscape fabric and staples along retaining wall, top off with mulch 34 in All egipment will be stored on private property at the installation address 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 Details 1. of Work to be Completed Does the utility owner have existing overhead infrastructure in the area of work? Yes No 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? x Are the additions for the purpose of serving a single-family residential subdivision? x Details of • to be Completed • 6. Does your project involve rebuilding or replacing utility equipment which currently serves more than one lot or commercial development? X 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: How many are existing? I I How many are to be added? 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: DATE: 3.22.22 APPLICANT PRINTED NAME: Jacob Tate 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 NW114, SW114. SEC. 8, TWP.27 N. RGE.4 E. W.M. % N _ DRK ARF—f\ _ 4 P• MGM ARTY, yl II V s II e ^� 4 r• ... + c� .n i n .a WRs C 4 q e �a xg WgE El 0 + •... v �..... Z N�YM[runw . ...nnr M i LU 0 ry! O Q .« PiW o..c Ot-1}pIP MY Pm 1OF1