ENG2023-0031 RE-ISSUED ROW PERMITRIGHT OF WAY EUC PERMIT
PERMIT NUMBER
City of • • .
Edmonds:iENG2023-0031
www.edmondswa.gov i
Description: PSE HYDROMAX-CCTV FOR 2022 WORK ISSUED: 03/13/2023
Address: 7110 210TH ST SW EDMONDS WA 98026-7219
EXPIRES: 12/31/2023
rmit Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 00566900600600
I 11-1411 a i
i
NAME TYPE NAME ADDRESS PHONE
APPLICANT JAIMEE FORMAN 6500 URSULA PL S, SEATTLE WA 98108 (206)702-8382
CONTACT HYDROMAX USA, LLC 6500 URSULA PL S, SEATTLE WA 98108 (206)702-8382
CONTRACTOR HYDROMAX USA LLC 6500 URSULA PL S, SEATTLE WA 98108 (502)851-6513
OWNER EDMONDS CITY OF 250 5TH AVENUE N, EDMONDS WA 98020
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
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: 03111312moo- 03/14/2023
This is a re -issued permit to correct typos in the expiration date and a condition on the permit initially issued 3/13/23.
Printed: Tuesday, March 14, 2023 9:55:55 AM 1 of 2
RIGHT OF WAY EUC PERMIT
PERMIT NU�IBEJ
City of Edmonds
www.edmondswa.gov • •
CONDITIONS
CONDITION TYPE
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.
Hydromax will annually provide the City with copies of the video. 2023 video shall be provided prior to
March 2024. If additional review and/or inspection time is needed, the City may charge additional
review fees and/or inspection fees.
If any repairs need to be completed on the sewer lateral and/or main line, a separate permit will need
to be obtained by the contractor completing the work. All repairs will need to be inspected by the City
of Edmonds. If all repairs will be completed by 1 contractor, we can issue one permit for the life of the
ENGINEERING OTHER
Hydromax permit. The City will add additional inspection fees as needed for each repair.
A traffic control plan shall be required for review and approval for major arterials (e.g. Edmonds
Way/SR104, Highway 99, 196th St SW/SR524, 212th St SW, 220th St SW, Olympic View Drive, and 9th
Ave /100th Ave W) or disruption of any intersections prior to work being completed. An inspection
shall be required and an inspection fee shall be added to the permit. If a uniformed police officer is
required, a City of Edmonds officer is required. Call the Edmonds Police Department.
ESC REQUIREMENTS
MAINTAIN EROSION AND SEDIMENTATION CONTROL PER CITY AND SWMMW STANDARD
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.
INSPECTIONS
SCHEDULE REQUIRED INSPECTIONS AS NOTED THROUGH MY BUILDING PERMIT.
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:OOam to 6:OOpm on
SOUND AND NOISE
weekdays and 10:OOam and 6:OOpm 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.
•
INSPECTION TYPE DATE
RESULT
NOTES
Iff
COMPLETE
A-1 JOB START
E-7 TRAFFIC CTRL
X-2 ENGINEERING FINAL"
Printed: Tuesday, March 14, 2023 9:55:55 AM 2 of 2
RECEIVED
JAN 20 2023
Lti�y of EpiyO�o�
ANC. 1 g90
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.
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 CCTV Sewer inspections for PSE's Cross Bore Safety Program.
Site Address or if no site address use Property Address at NW corner of project area: City wide, Please see attached list
Associated Permits: BLD PLN ENG
• applicable)
Name of Company PSE/Hydromax USA Franchise Ordinance No:
Point of Contact Jaimee Forman
Title Municipal Liaison Manager
Address 6500 Ursula PI S
city Seattle
state WA
zip 98108
Phone 206-702-8382
Email jaimee.forman@hydromaxusa.com
Contractor and Authorized Agent of Owner (see note below)
NameofCompany Hydromax USA
Contractor Contacts During Construction
Primary Name N/A
Agent Name Jaimee Forman
Title
Title Municipal Liaison Manager
Mobile
Address 6500 Ursula PI S
Email
City Seattle
IState WA
Zip 98108
Secondary Name
Phone 206-702-8382
Title
Email jaimee.forman@hydromaxusa.com
Mobile
City of Edmonds Business License No: #N R-026397
Email
State License No: 603 250 097
IN 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?
x 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
N 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.)
CCTV Sewer Inspections for PSE's Cross Bore Safety Program. Non-invasive annual routine maintenance.
30-90 minutes per location
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?
•
2.
Will any equipment be added underground or above ground (e.g. pedestals, vaults, etc.)?
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?
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?
5.
Does the work involve proposed additions to an aboveground utility system? If es:
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
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:
How many are existing? I I How many are to be added?
6b.
Does your project involve poles? If yes:
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:
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 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: 1.19.23
APPLICANT PRINTED NAME: Jaimee Forman
APPLICANT TITLE: Municipal Liaison Manager
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
City of Edmonds ROW construction permit Application --Page 3 of 3 Updated 3/25/2021
AddrPc,c,Pc,
17715 76TH AVE W
17901 VISTA DEL MAR DR
23135 75TH PL W
SEE ATTACHED APPROVAL FROM
CITY OF LYNNWOOD TO SCOPE
THEIR SEWER MAIN IN CITY OF
EDMONDS RIGHT-OF-WAY
23129 75TH PL W SEE ATTACHED APPROVAL FROM
23104 106TH AVE W OLYMPIC VIEW WATER & SEWER DISTRICT
FOR SCOPING THEIR SEWER MAIN IN CITY
23911 107TH PL W OF EDMONDS RIGHT-OF-WAY
23218 74TH AVE W
23931 76TH AVE W
23504 84TH AVE W
8820 192ND ST SW
ENGINEERING DIVISION
"DTED
IF ADDITIONAL SITES ARE ADDED AT THE FOLLOWING LOCATIONS,
TRAFFIC CONTROL INSPECTION(S) AND ADDITIONAL FEES WILL BE
REQUIRED:
EDMONDS WAY/SR104
HIGHWAY 99
196TH ST SW
212TH ST SW
220TH ST SW
OLYMPIC VIEW DRIVE
9TH AVE (SOUTH OF CASPERS)
100TH AVE W
Applicant shall repair/replace all
damage to utilities or frontage
improvements in City right-of-way
per city standards that is caused or
occurs during the permitted project.
OWNER/CONTRACTOR IS RESPONSIBLE FOR
EROSION CONTROL AND DRAINAGE
OWNER/CONTRACTOR RESPONSIBLE FOR LOCATING
ALL ON SITE UTILITIES. RELOCATION/REVISION TO ANY
UTILITIES MAY REQUIRE A SEPERATE PERMIT.
13/01 /2023
RECEIVED
JAN 20 2023
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
From: Andrew Lorenzen <ALorenzen@lynnwoodwa.gov>
Sent: Friday, February 24, 2023 11:05 AM
To: Glenn (Andy) Kirkbride <andykirkbride@hydromaxusa.com>
Cc: Jared Bond <JBond @Ivnnwoodwa.gov>; Kris Olsen <KOlsen@lynnwoodwa.gov>
Subject: [EXTERNAL]: RE: [EXTERNAL]: RE: [EXTERNAL]: Sewer Main @ Edmonds Community College
CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the
content is safe.
Good morning and thank you for providing the requested information.
Permission granted. You may enter the system for inspection at the location outlined in this chain, but I do have one ask...
Please provide my office with a 24-advance notice of the intended start date and time.
This will allow us to track your progress in real time and secure the manhole to our standards once the work is complete.
As you may or may not be aware, there is an ongoing issue with odors related to the gravity trunk in that area, and many of the manhole covers require
additional means to prevent them from gassing off.
Thank you and have a great weekend!
Andrew Lorenzen, Foreman
Public Works Utilities Division
Office. 425.670.5243
Cell. 425.754.9768
From: Billy Ward <billyw@ovwater.com>
Sent: Monday, February 6, 2023 3:00 PM
To: Jaimee Forman <laimee.forman@hydromaxusa.com>
Cc: Erica Richter <EricaR@ovwater.com>
Subject: [EXTERNAL]: RE: Phone Call Follow-up, PSE/Hydromax USA ROW/ Sewer access
CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the
content is safe.
Hi Jaimee
After looking into your question about access to our sewer system for cross -bore assessment. We do not require a permit to access our sewer system to
CCTV for cross -boring. We only ask for a heads -up notification from one of your field technicians prior to accessing our sewer system. They can call the office
at (425)774-7769) or email me at billyw@ovwater.com. Hope this answers your question and let me know if you need anything else from me. Thank you
and have a great rest of your day.
LEGENDS
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105
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WITH DATE & TIME CLEARLY POSTED AND NOT OBSTRUCTING
PARKING ACCESS UNTIL THE SPECIFIED DATE & TIME.
Applicant shall repair/replace all
damage to utilities or frontage
improvements in City right-of-way
per city standards that is caused or
occurs during the permitted project.
OWNER/CONTRACTOR IS RESPONSIBLE FOR
EROSION CONTROL AND DRAINAGE
OWNER/CONTRACTOR RESPONSIBLE FOR LOCATING
ALL ON SITE UTILITIES. RELOCATION/REVISION TO ANY
UTILITIES MAY REQUIRE A SEPERATE PERMIT.
WARNING SIGN SPACING = X
35-40 MPH 1 350'+/- 1350'+/- 1 350'+/-
25-30 MPH 200'+/- 200'+/- 200'+/-
ENGINEERING DIVISION
..,DTED
13/01 /2023
RECEIVED
JAN 20 2023
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
WARNING SIGN SPACING - X
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2&M MPH I 200'+/- 2=W+/_ 2W+N
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RECEIVED
TRAFFIC CONTROL INSPECTION SHALL BE
REQUIRED WHENEVER WORK ZONE IS SET UP JAN 20 2023
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
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MINIMUM TAPER LENGTH = L
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25
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35 40 45 50 55 60 65 70
10
205
270
450
500
550
11
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36�0 MPH 95p+� 350+f 350+4 350+/-
25-W MPH 200'+I- 200W+f 2W+4- 2W,+/-
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
TRAFFIC CONTROL INSPECTION SHALL BE
REQUIRED WHENEVER WORK ZONE IS SET UP
MINIMUM TAPER LENGTH = L
LANE
WIDTH
(FEET)
POSTED SPEED (MPH)
25 30 35 40 45 50 55 60 65 70
10
105
150
1 205
1 270
450
1 500
1 550
11
12
115
165
225
1 295
295
1 550
1 605
1 NO
125
180
1 245
1 320
540
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780
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60/65 MPH
800'+/-
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45/55 MPH
500' +/-
RURAL ROADS & URBAN
ARTERIAL
35/40 MPH
350' +/-
RURAL RD, URBAN
ARTERIAL, RESIDENTIAL,
BUSINESS DISTRICTS
25/30 MPH
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A PROTECTIVE VEHICLE IS RECOMMENDED REGARDLESS IF
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VEHICLE SHALL BE STRATEGICALLY LOCATED IN THE FIELD TO
SHIELD WORKERS AND NO ROLLAHEAD DISTANCE IS SPECIFIED.
MINIMUM TAPER LENGTH = L
LANE
WIDTH
(FEET)
POSTED SPEED (MPH)
25 30 35 40 45 50 55 60 65 70
10
105
150
205
270
450
500
550
11
115
165
225
295
295
550
605
660
12
125
180
245
1 20
1 540
1 600
660
720
780
840
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800' +/-
RURAL ROADS
45/55 MPH
500' +/-
RURAL ROADS & URBAN
ARTERIAL
35140 MPH
350' +/-
RURAL RD, URBAN
ARTERIAL, RESIDENTIAL,
BUSINESS DISTRICTS
25/30 MPH
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VEHICLE SHALL BE STRATEGICALLY LOCATED IN THE FIELD TO
SHIELD WORKERS AND NO ROLL AHEAD DISTANCE IS SPECIFIED.
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STOPPINGISIGHT DISTANCE
RI IFFFR RPArF
SPEED (MPH)
DISTANCE (FT)
20
115
25
150
200
250
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305
50
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75
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.... CHANNELIZING
DEVICE
M ADVANCE WARNING
SIGN LOCATION
® WORK VEHICLE
SEQUENTIAL
® ARROW BOARD
HYDROMAX USA
LEFT LANE CLOSURE
ON ATWO LANE ROAD
STOPPING/SIGHT DISTANCE
RIIFFFR RPACF
SPEED (MPH)
DISTANCE (FT)
20
115
1.
155
30
200
45
360
50
425
495
1 60
570
us
75
820
TEM .TRAFFIC
DIRECTION
.... CHANNELIZING
DEVICE
14 ADVANCE WARNING
SIGN LOCATION
® WORK VEHICLE
SEQUENTIAL
® ARROW BOARD
RECEIVED
JAN 20 2023
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
LEGENDS
rFLAGGER
STATION
F
TRAFFIC
DIRECTION
a
TEM .TRAFFIC
DIRECTION
„.
CHANNELIZING
DEVICE
N
ADVANCE WARNING
SIGN LOCATION
®
WORK VEHICLE
MAINTAIN 11' MIN.
LANE WIDTH
28- TRAFFIC CONES �c
�4AHFA.
+XROAD AHERADD
t>
W20-1 W204 W20-7A
0
HYDROMAX USA
LANE CLOSURE
MH NEAR STOP SIGN
ON RESIDENTIAL STREET
X- DISTANCE BETWEEN SIGNS
36.40 MPH 3W+/- 3W+/- 3W+/- 3W,- -
Y+/-
X
- W20-7A
X
_ _ ONE LANE W20-4
ROAD
AHEAD
X
ROAD
_ - WORK W20-1
AHEAD
TRAFFIC CONTROL INSPECTION SHALL BE
REQUIRED WHENEVER WORK ZONE IS SET UP
RECEIVED
JAN 20 2023
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
SIGN SEQUENCE A
W20-4
W20-7A __ W20-1
ROAD
�� naw�
X X X
LEGENDS
rFLAGGER
STATION
TRAFFIC
DIRECTION
a
TEM .TRAFFIC
DIRECTION
....
CHANNELIZING
DEVICE
M
ADVANCE WARNING
SIGN LOCATION
®
WORK VEHICLE
ATTACH SIGN
SEQUENCE (A)
50' MIN. f
100' MAX.
6 DEVICE MIN. 1
►I_ I
X X
-50' MIN.
100' MAX.
6 DEVICE MIN.
W20-1 W20.7B W20-7A
NOTES:
1. FLAGGER STATION SHALL BE IN LINE OF SIGHT OF APPROACHING VEHICLES.
2. FLAGGER SHALL MAINTAIN RADIO COMMUNICATION.
3. FLAGGERS TO ASSISTS PEDESTRIANS ACROSSIAROUND WORK ZONE.
HYDROMAX USA
28'TRAFFIC ROUNDABOUT
a CONES
i ATTACH SIGN
50' MIN. SEQUENCE (A)
100' MAX.
6 DEVICE MIN.
�q
50' MIN.
100' MAX.
6 DEVICE MIN.
Ix
W20.7A
*X/
o� ° W20-7B
Ix n
TRAFFIC CONTROL INSPECTION SHALL BE
REQUIRED WHENEVER WORK ZONE IS SET UP
RECEIVED
JAN 20 2023
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT