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ENG20170129-APPROVED PERMIT.pdf41o"� CITYOFEDMONDS 1215THAVENUENORTH- EDMONDS, WA 98020PHONE: (425) 771-0220 - FAX: (425) 771-0221 h�C. *PE'RrVO " MUST BE POSTED ON JOBSITE* Location: 7232 212TH ST SW 1525 75TH AVE SW, #200 C/O MARTIN KOSULJANDIC Attn: Mike Fontenot 6501 212TH ST SW EVERETT, WA 98203 LYNNWOOD, WA 98036 (425) 361-7802' LICENSE #: HORIZCI006DS EXP: 05/12/2017 uirectional drill (1) L" conault y-')' trom existing pore,to private property, set pea DISRt,JPTION INFORMATION ASSESSED VALUE: $0,00 PROPERTY AREA: 0 SIDEWALK: (OXO) DURATION IN MONTHS: 0 FEE. $0,00 STREET DISRUPTION TRENCH CUT: 10 X 0 ) PARKING ( OXO ) DURATION IN MONTHS: 0 FEE $0,00 YEAR OF OVERLAY a 0 FEE: $0,,00 ALLEY: ( 0X0) DURATION IN MONTHS: 0 FEE. $0,00 INDEMNITY- The Applicant has signed an application which states he/she holds the City of Edmonds harmless from injuries, damages or claims ofany kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds or any ofits,departments or employees, including but not limited to the defense ofany legal proceedings including defense costs and allorney fees by reason ofgranting this permit. THE CONTRACTOR IS RESPO NSIBLE FO R WORKMANSHIP AND MATERIALS FORA PERIOD OF ONE YEAR FOLLOWING THE FINAL INS PEC TIO N AND AC C EPTANC E O F THE W O RK . 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 possesion. • 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. « Three sets of construction drawings of proposed work are required with the permit application. CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION CALL FOR INSPECTION :(425) 771-0220 EXT. 1326 24 HOUR NOTICE RFQUIRED'FOR ALL INSPECTION REQUESTS'' THIS I"1PLJ(,',ATION`ISNOTAPERMITUNTIL' SIGNED BYTHE CITY ENGINEER 'ORHIS/HERDEPUTY: AND 'FEES ARE PAID SPACE PROVIDED, 511, RELEASED BY VD; D FILE COPY INSPECTOR COPY Printed '20 7 Fri - da w Ma 12, 201 ❑ APPLICANT COPY • Restore ROW to City standards • Restore Landscape to like or better conditions. • Call for locates of underground, utilities prior to any excavation. • Alert affected residents and/or businesses prior to work start. • Conform to approved working drawings and Traffic Control plan. • Verify clear bore crossings • Utility patch restoration to be in accordance with Edmonds Standard detail E2.3 • Maintain erosion & sedimentation control. Keep street clean. • Call for required inspections as noted. • Traffic Control per approved plan and MUTCD. Refer to City of Edmonds traffic control requirements. • Applicant shall repair/replace all damage to utilities or frontage improvements in City right-of-way per City standards that is caused by or occurs during the permitted project. • Sound/Noise originating, from temporary construction sites as a resultof construction activity are exempt from the noise limits of ECC Chapter 5.30 only during the hours of 7:00am to 6:00pm on weekdays and 10:00am and 6:00pm on Saturdays, excluding Sundays and Federal Holidays. At all othertimes the noise originating from construction sites/activities must comply with the noise limits of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120. • Applicant, on behalf ofhis 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 issuance of this permit. Issuance of this permit shall not be deemed to modify, waive or reduce any requirements of any City ordinance not limit in any way the City's ability to enforce any ordinance provision. • E -Traffic Control a F Engineering Final PARTIAL INSPECTION DATE; INITIAL: NOTES: PARTIAL INSPECTION DATE: INITIAL: NOTES: FINAL INSPECTION APPROVED DATE: INITIAL: N.:� SCANtXb APR 19 2017 APR(�: 2017 ROW PERMIT NO.: ENG 'a©f®CSI 3.� ISSUE DATE: RIGHT-OF-WAY CONSTRUCTION PERMIT APPLICATION PROJECT NAME: MDU JT# 218452 CONTRACTOR: Horizon Communications Inc. MailingAddress: m._ 6501 212th ST�SW State License #: HORIZCI006DS ............ ..... City Business License #: TBD CONTACT: Holly Munyan Phone #: 425-361-7802 Fax #: 425-582-2926 Email #: hmunyan@horizonnw.net Liabifit" Insurance ................ � Bonded ADDRESS OR INTERSECTION OF CONSTRUCTION: 7232 212th ST SW, Edmonds ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT: Commercial Subdivision ❑ City Protect Traffic Control(Only) ® Multi -Family ❑ Single Family E, Other XI EUC (PUD, VERIZON, PSE, COMCAST, OVWSD): Is this permit part of a blanket permit? ❑ Yes X❑ No -W ANY AS :PPE:RMIT::S:?:] DESCRIPTION OF PROPOSED WORK (Be Specific) :...... Directional drill (1) 2" conduit 95' from existing pole to private property, set ped.. WAS STREETwOVERLAYED () WITHIN THE LASTmFIVE 5 YEARS? YES NO Year: PAVEMENT CUT: []Yes ® No If yes, indicate size of cut: x, ® No If y , CONCRETE CUT: Yes es indicate size of cut: x RIGHT-OF-WAY DURATION CLOSURE AREA TOTAL (NUMBER OF MONTHS) Sidewalk 48 Hrs + LF X LF SF Alley 72 .Hrs + LF X _ LF SF Parkin. 72 Hrs + ............. LF X LF... Parking SF 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 statements and understand the permit requirements and acknowledge that I must follow all requirements in order for the permit to be valid. SIGNATURE � L' DATE 4/16/17 S Contra ctor or Agent NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE mfr N w F Z Z m � F� J W V) < w�w d f FW KKQ p O y a Oo N W ° 0 w aL z m ¢ Z U F a o W W U S a z ❑ 5 ° ~ Z m WW> K W 2 W Q W hZ aQa U ❑ Z y N R 2 vI ,IZj U U O F N b ww of J o uXi ❑ � � W n a z r n m O rIn c til fi �o 9 ® b _ Eo CL w a a � oma Q °s,a000 �a F\ Z zN J x WIN Z 4 J 0 m nY O O LL o W z W II �z m a U) x RM J LL $: ® 8 9 ® Wo Z' 4 ®w J LL p z H �' 4 x U) M � J ct 42 .......... 3 V a r W � z W C vJ ti'C Q a �3 9 z o. _m m 3 a W s _.... _ z a. ®LU g F 0 i w C __..., ........ 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