Edmonds LS1 Right of Way Construction Permit - Geotechnical.pdfi 'of EE)klo�v
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PROJECT NAME: Geotech. Borings -Sunset Ave. CONTACT: Mike Harney, P.E.
CONTRACTOR: Shannon & Wilson, Inc.
Mailing Address: 4-0"34fliSt., Suite 10-
I Box 300303.
State License #: 578 058 207
City Business License #: 1qK_
Phone #: 206.695.6850
Fax 4: 206.633.6777
Email #: MDH@shanwil.com
Liability Insurance &FBonded
Four geotechnical borings taken on Sunset Ave. N. between
ADDRESS OR INTERSECTION OF CONSTRUCTION: Main Street and Caspers Street.
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
F-1 Commercial 0 Subdivision V City Project E:1 Traffic Control (Only)
❑ Multi -Family El Single Family
❑ EUC III VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit.?
I ANY ASSOCIATED PERMITS? �
F-1 Other
W�IEWW
BLD# I ENG# NA
II,' III I'l III 'Roll
01milrilli I Ili 1 r1i inf W1 1203YUG,�:A �1, B�l I
PAVEMENT CUT: VYes F1 No If yes, indicate size of cut: approx x 6"-8" dia.
CONCRETE CUT: F Yes F No If yes, indicate size of cut: x
RIGHT-OF-WAY DURATION
AREA TOTAL
CLOSURE (NUMBER OF MONTHS)
J
Sidewalk 48 Hrs + LF X ]LF SF No impact
Alley 72 Hrs + LF X LF SF No impact
Parking 72 Hrs + LF X LF SF Less than 72 hrs*
*See attached plan
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
follow all reauiremer
SIGNATURE
and understand the permit requirements and acknowledge that I must
for the permit to be valid.
or Agent
DATE 67