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ENG2021-0164 ROW PERMITOF WAY EUC PERMIT PERMITNUMBER, City of Edmonds EdmondsRIGHT 121 98020 1 1 www.cityofedmonds.gov Description: OVWSD-RESTORATION FOR EXPIRED PERMIT ENG2019-0554 ISSUED: 05/17/2021 Address: 24320 87TH PL W EDMONDS WA 98026-9005 EXPIRES: 11/17/2021 rmit Type: RIGHT OF WAY EUC Permit Subtype: MINOR Parcel Number: 00665900000200 i NAME TYPE NAME ADDRESS PHONE APPLICANT OLYMPIC VIEW WATER & SEWER EDMONDS WA 98026 (425)774-7769 DISTRICT CONTRACTOR OLYMPIC VIEW WATER & SEWER EDMONDS WA 98026 (425)774-7769 DISTRICT OWNER SCOVILLE CHRISTINE B & DAVID 24320 87TH PL W, EDMONDS WA 98026-9005 FEE INFORMATION DESCRIPTION AMOUNT PAID CITY TECHNOLOGY FEE CHARGED PER PERMIT $40.00 $0.00 RIGHT OF WAY MINOR - EUC PERMIT FEE $110.00 $0.00 THIS DOCUMENT IS NOT VALID UNTIL FEES ARE PAID AND THE CITY ENGINEER OR HIS/HER DEPUTY HAS SIGNED BELOW 05/17/2021 RELEASED BY (/ V DATE Printed: Monday, May 17, 2021 7:39:57 AM 1 of 2 -KRWOF WAY EUC PERMIT City of • • • •:• •ENG2021-016 www.cityofedmonds. ov/425.771.0220 CONDITIONS CONDITION TYPE Easement and/or permission from adjacent property owner is required prior to entry or work within ADJACENT PROPERTY an adjacent property. 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. Alert affected residents and/or businesses prior to work start. Verify clear bore crossings. ENGINEERING OTHER Restore landscape to like or better conditions. Call for required inspections as noted. ESC REQ 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. Sound/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 OR 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/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 COMPLETE F7 A-1 JOB START X-2 ENGINEERING FINAL** Printed: Monday, May 17, 2021 7:39:57 AM 2 of 2 ENG2021-0164 ��of EVAtOyl RECEIVED RIGHT OF WAY CONSTRUCTION MAY 06 2021 PERMIT APPLICATION Complete and submit this Application in accordance with the Submittal CITY OF EDMONDS INC. IS90 Requirements outlined in Right -of -Way permit Handout E63. 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. SECTION A mime 61111 Project Name Site Address or if no site address use Property Address at NW corner of project area: 2 LIDO 07 to w Associated Permits: BLD PLN EATG Holding -Oxviier and Entity Frandiise (if applicable) Name of Company 0� i , A / Franchise Ordinance No: Point of Contact �J , Title Address 8 k 2 City d State Li Zip �2 Phone U z� 77 — Email G -Conti,actor and Autliorized Agent of Name of Company W i C v, ew Owner (see note below)jIIIIIIIIIIIIIIIIIIII, ' , ,- 3Xk`` Contractor Contacts DUring COIIStrUCtiOn PrimaryName Agent Name t� 'r itle Title r. Mobile Address e) 2-0 22-8 S. , 64/ Email City Stave'_ zip L Secondary Name Plione y 77-1 ^ 0 Title Email ub4eT Mobile City of Edmonds Businels License 1\To: Email State License ATo: Contractor verifies it is currently bonded Contractor verifies it currently has general liability insurance A107W: ECDCj8.6o.o2o requires that the Application be signed by a licensed and bonded contractor unless otherwise approved by the city engineer. Type of Development — Cheek ALL that apply I ❑ Multifamily residential ❑ Commercial ❑ City project ❑ Single family residential subdivision ❑ Single family -other ❑ Industrial ❑ Demo and rebuild or from vacant land? ❑ Other, please specify: ❑ Utility Franchise Work associated with development (check one of the above boxes as tveln ❑ Traffic Control Only (no associated development) ❑ Utility Franchise Work (no associated development) City ofEdmonds ROW construction permit Application --Page i of 3 Updated 3/25/2021 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.) Q&_5-t w. --Qor o—)< r--e-J rPrwt "4- CNCn 20H 0551 RIGHT-OF-WAY CLOSURE AREA TOTAL DURATION (Number of Months) Sidewalk 72 hours + LF x LF SF Alley 72 hours + LF x LF SF Parking 72 hours + I LF x LF SF SECTION B - If you are not a utility company performing work in the Cihj ROW, skip to SECTIONC. Type of Utility Facilities 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 of Work to be Conipleted i. Does the utility owner have existing overhead infrastructure in the area of work? Yes No 2. Will any equipment be added underground or above ground e.. 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? 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 stem? 5. Does the work involve proposed additions to an above round utility system? If yes: 154 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? • Mr Se • . 6. Does your project involve rebuilding or replacing utility equipment which currently serves more than one lot or commercial development? 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? City of Edmonds ROW construction permit Application --Page 2 of 3 Updated 3/25/2021 6b. Does your project involve poles? If yes: I 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? I I What is the height of the poles after? Describe the modification rebuild: SECTION C 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. Insiu ance. 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 penury 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: APPLICANT PRINTED NAME: APPLICANT TITLE: NO IVORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE City of Edmonds ROW construction permit Application --Page 3 of 3 Updated 3/25/2021 APPLICATION FROM EXPIRED PERMIT ENG2019-0554 OLYMPIC VIEW WATER & SEWER DISTRICT EDMONDS BLANKET PERMIT BEGINNING NOTIFICATION Site Address: 24320 87th pl W Scope of Work: Repair leaking water service ,�tiC/ gev%Dv 51 tLGOO OV"4AUP Zolit - CtAT r t- f J_144LL 4PPI.V _ e-41,c roa, (LES1"oI�AT�Cv L�wl�r7 /NSPE��rr• ZO ; o+4r P n-! wP -1G oiv Fl L . Asphalt or Concrete Cut: Yes Olympic View Water & Sewer District 8128 228th ST SW Edmonds WA. 98026 Phone Number 425 774 7769 Fax Number 425 670 1856 Contact: Marty Henninger E-mail: marty@ovwater.com Start date: 12/5/2019 Olympic View Water & Sewer District 8128 228th ST SW Edmonds WA. 98026 Phone Number 425 774 7769 Fax Number 425 670 1856 Contact: Cody Gray E-mail: Cod yG@ovwater.com • Traffic control shall be in accordance with the MUTCD. • All flaggers shall be trained and certified as required by WAC 296-155-305. • Restoration shall be in accordance with City of Edmonds standards. • All asphalt or concrete cut surfaces shall be patched with City of Edmonds approved materials prior to the end of the day. ENGINEERING DIVISION APPROVED AS NOTED OWNER/CONTRACTOR IS RESPONSIBLE FOR Applicant shall repair/replace all EROSION CONTROL AND DRAINAGE 05/14/2021 damage to utilities or frontage improvements in City right-of-way per city standards that is caused or F`1�' EC E I/ E D occurs during the permitted project. O:\SHARE\PERMITS RIGHT OF WAYS\Edmonds DEC 0 5 2019 ENGINEERING DIVISION