McCammant PSE ROW Permit 031208FPOM FA;; N0. S°~91 P1ar. 18 2038 @9:23AM P2~2
City of Xelm
Community Development Department
105 Yelm Avenue West
P.Q. BoK 479
Yelm, OVA. 98597
Phone: 360-458-3835
FAX: 360--158-3144
Permit No.
Application to Perform Work on
Public Right of Way and/or Connect
to Utilities
APPLICATION
The undersigns ereby maker application ko:
Q ~_..~ -. d ZN S~c~-lam'' ~'c- c:~ ~~v c ~" 6 s~
,L`~.. r ~1•` i G'~ tV ~' f~, l N f '~`~t~ CL- ~ ~~" C~ tom! `'z. V`L--
Lacatioai of work: ~ Q 5 Uj~ `% y~-~.. ~ ~'.1 ~S~ ,-, c.,.~
I agree to perform the work in strict campli::Ence with 'elm Municipal Cade, Chapter ,the specia
conditions enumerated herein and the attached conditions .I have read and will adhere to the general provisions
a licable to ermits contained on this forn-t.
TheCommurttty ~t~velopiment Depa>~trrient (36a 4S8 ,3835) mush b'e contacted for inspection 24 Naurs
efare work coiintn Hess ar illiis: errni iNill=be void':
The Underground Utilities Coordinating Council (I-800-424-5555) must be contacted two (?) working days
before roceedin with an excavation associated with this e>imit.
Name: `~' ~~ ~.1
Address: c r G ~. `~ CSC.-Y 4'' . PPhone: ~C,C> - 7 -- .'~-,~1'
Proposed starting date of installation: Duration:
Date: ~-~ -~PJ Signature: r--µ f~~_. l~~~t~- ' Li-! n~..T I~f ~1 NS~' ~i~>Cal'-t
PERMIT RE UIREMENTS
For Official Use Only
Fee $ I~>sued ~ --Z~--~~
Fee Received $ Application Approv ,
~
ReeeiptNumber Signature: ~~ ~-.--~`
~~--~->
To Be Corn feted B
Permission is hereby granted to perform the above described rk subject to the general provisions contained
on this form, and the followin s ecial conditions:
~.~n,t ~ t ~ A-fi~;ar~ "w L -t-«~ ,~n.a ~a -~~ ~_ f:~ Y~.c,~ (' ~' l~s
A bond in the amount of is required to insure compliance with the above
conditions, refundable u on satisfacto com letion of work.
No work shall be done under this permit tuft it the party or parties to whom it is granted shall have
communicated with and received instructions from:
Remarks:
Fuse Inspection
Date: lnspectar Final Project
Corn letion A royal: ,t;tr~„ ~ -~ , Date:
CDD DatnlForms & procedureslRight of Way PermitlDRAFT - Right of W;ry permit E.Joc
RECEtVEQ
FE8 0 ~ 2008
FRQht FAQ N0. 5991 htar. 1~ 2®02 09:23AM P1!2
POTELCO INC
A Oaeata 6Nrltaa Gprapar.y
New Customer Construction Dept. RepreSerlting
ThurstonlLewis Counties
2711 Pacific Ave NE, Olympia, WA 98501
TO: CITY OF YELM
_
ATTN:
DATE JIM GIBBON
March 10, 2008
TEL #
FAX # 360-458.3144
# of Pa es _
2 ._
RE: 903 BRYSTAL SPRINGS RG NW
_~~~ ~QV ~ ~~~~
FROM
PUG ET
SOUND
ENERGY
Corinna Hoover
TEL # 360-786-5931
FAX # 1-866-761-0769
Corinna hooverC~pse.com
Dear Jim,
Please find the revised application for the above named address.
Per Chris with A Action this wiq be an o en cut vs. a road push to install conduit across
Crystal Springs Rd. for power service:
Please let me know if you have arty questions.
Thank you,
Car%vu~,ov ~Eoaver
Potelco, Inc.
Olympia Service Center
(360) 786-5931 or 85-5931
Fax: 1-866-761-0769
Corin na. HooverCa)ase.com