Issued ROW Permit ENG20190275.pdfv� O, LY'O��
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
/nc. 1 x90
*PERMIT MUST BE POSTED ON JOBSTTE*
STATUS: ISSUED ENG20190275
RIGHT OF WAY PERMIT (6-EUC)
Permit Number: ENG20190275 Expiration Date: 01 /02/2020
Job Address: 9828 CHERRY ST, EDMONDS Location: 9828 Cherry ST
COMCAST
GO JOURDEN LA W RENCE
1525 75TH ST SW
EVERETT, WA 98203
Prince Telecom
13701 24th ST E Bldg G
Sumner, WA
(425)921-8201
LICENSE #: PRINCTL862PS EXP: 10/10/2020
Starting fromthe PED located in between houses for 9826 and 9826, will bore 14 feet west.
DISRUPTION INFORMATION
ASSESSED VALUE: $0.00 PROPERTY AREA: 0
SIDEWALK: (OXO) DURATION IN MONTHS: 0 FEE: $0.00 STREET DISRUPTION TRENCH CUT: ( 0 X 0 )
PARKING: ( OXO) DURATION IN MONTHS: 0 FEE: $0.00 YEAR OF OVERLAY: 0 FEE: $0.00
ALLEY: ( OXO) 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
attorney fees by reason ofgranting this permit.
THECONTRACTOR IS RESPONSIBLEFOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONEYEAR FOLLOWING THEFINAL
INSPECTION AND ACCEPTANCE OF 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 pennit application.
CALL DLAIrA-DIG (1-800424-5555) BEFORE ANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT.1326
24 HOUR NO TICE REO UIRED FOR ALL INSPECTION REO UESTS
THIS APPLICATION IS NOTA PERMITUNTIL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPTIS ACKNOWLEDGED IN
SPACE PROVIDED.
BY
Printed: Tuesday, Ju
A/ 1q
DATE
0 FILE COPY ❑ INSPECTOR COPY 7 APPLICANT COPY
STATUS: ISSUED
ENG2O19O275
• 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 pemvtted project.
• Sound/Noise originating fromtemporary construction sites as a result of construction activity are exempt fromthe noise limits
ofECC Chapter 5.30 only during the hours of7:00amto 6:OOpmon weekdays and 10:00amand 6:OOpmon Saturdays, excluding
Sundays and Federal Holidays. At all other times 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 of his orher spouse, heirs, assigns, and successors in interests, agrees to indemnify defend and hold
hamnless the City of Edmonds, Washington, its officials, employees, and agents from any and all claims for damages of
whatevernature, arising directly or indirectly fromthe issuance of this pemut.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-Engineering Final
PARTIAL INSPECTION
PARTIAL INSPECTION
FINAL INSPECTION APPROVED
DATE:
INITIAL: NOTES:
DATE: INITIAL: NOTES:
DATE: INITIAL.
Qf EDA.tO�
ANcT i s90
I
ROW PERMIT NO.: ENG ;WVt9 JJr
ISSUE DATE: _ 4 Z/ lot
RIGHT-OF-WAY CONSTRUCTION RECEIVED
PERMIT APPLICATION JUN 13 2019
PROJECT NAME: Corn�asa V�$�G
CONTRACTORrtna ,Tit.�s.�+�.
Mailing Address; l.$ 01 I)qdh Sf £ 1 6 . G
State License #:
�nt4CCF'L`Kto��S yB3jo
City Business License #:
CONTACT:ENGINEERING DIVISION
�OUrd
�-G.tcs m V1. C-2
Phone #: �Qs- qg l- go m
Fax #:
Email #• rdI — Law Vence Oamcas5 -co
Liability Insurance El Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: qU8 ' YY-.t
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
Commercial
❑ Multi -Family
Subdivision
❑ Single Family
❑ EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this pen -nit part of a blanket permit?
City Project
❑ Other
❑ Yes ❑ No
Traffic Control (Only)
ANY ASSOCIATED PERMITS? BLD# _. _.. ENG#+`
DESCRIPTION OF PROPOSED WORK (Be Specific), �2ACk6tyNq Xrr%rc% Aing. 261)
"J
IUCc oc1 in beAwgtgAn low- �'ur 9 gak �a, C��a$,..wt t "
*� 4X. info (k Co?q 0; ISSved %wh�4 4o rtnavi)oc1/3 v\tAy 5is►r.vtr.d ,�au+r,�l,Cc.m
WAS STREET OVERLAYED WITI1IN THE LAST FIVE (5) YEARS? YES ND Year: J
PAVEMENT CUT: ❑ Yes E - No If yes, indicate size of cut: x
CONCRETE CUT: ❑ Yes �;--No If yes, indicate size of cut: x
RIGHT-OF-WAY
AREA
CLOSURE
TOTAL
DURATION
ffUMBER.OF MONTHS)
Sidewalk 48 Hrs + LF
X LF
SF
Alley 72 Hrs + LF ', X j LF
Parking 72 Hrs + LF X LF
SF
SF
w
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 (WAQ 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 fo the permit to be valid.
SIGNATURE DATE (:1 ill / q
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
2003 Edition
G
Figure 614-6. Shoulder Work with Minor Encroachment (TA-6)
A
spa 171ty
I
Page 6H-17
END
t—,`ROAD WORK
Note: See Tables 6H-2 and
6H-3 for the meaning
of the symbols and/or
letter codes used in
tthis figure.
APPROVED AS rjo-T
3 in
(10 ft)
MIN.
Truck -Mounted
Attenuator
(optional)
Buffer space
(optional)
0
Typical Application 6
1/3 L
A
ROAD
WORK
AHEAD
r
VEVUUL
COMCaSt. CSG Locaten:�^ J'r Drop Buryll: 2 MDatey5jffijy Node: Bury Drop
Customer Mime: C b Tl"f , D vsv Phonelt :1� b) Vct
Address: I ?- city_ (%�� ZIP �g(�ocross Strer_t: Ave 1
:]Servk:e Effecting ❑Uut of Service ❑Needs Install []Needs Cutover Tecltlr : Tech Cell:
Type of Bury.,
STH Foota6e
ROW Footage
Permit R tired: Y N
Back Yard Easement: Y lJ
Sidewalk Bore
_
Planting Strip: Y
N it
Sprinkler System: Y N
Driveway Bore
Sidewalk: Y Fn
N j
Septic Field: Y N
Landscape Bore
Road Edge: YO
N
Drain Pipe: Y N
Private Water:
Road Born
Curb: Y
NO
Soft Surface
Bury Foot Total:
Private Wiring: Yo NE]
What Kind?
Total:
Total:
Total pro Footage;
Customer Present For Bury: Y(] Nj] Call Customer First: YU N❑
Best rl For Customer:
Comments
CUSTOMER CONTACTED AND REVIEWED ROUTING OF NEW DROP Y[] I NOT HOME, Lm DOOR TAG YLJ
Being the owner of the above property, I hereby give my permission to Comcast, or their duly authorized representative
to bury a service line on my property. Property Owner's Signature:
rrRand
TV
Existing Carson -
PIRct Orson •
Sawcr - •
Pole -
Phone •
siraat tight
Power-N
Catch Basin -
Ges (a
Nonticr.�
P+�e HvL"nt- If
Wator/irde+tUon - A
Mnll Box-