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20160199 ROW Permit 05052016City of Yelm Community Development Department Building Division Phone: (360) 458 -8407 Fax: (360) 458 -3144 Applicant: Name: PUGET SOUND ENERGY Address: 2711 PACIFIC AVE SE OLYMPIA, WA 98506 Property Information: Site Address: 15624 COATES RD SE Assessor Parcel No.: 22719230400 Subdivision: Contractor Information: Name: PUGET SOUND ENERGY Address: 2711 PACIFIC AVE SE OLYMPIA, WA 98506 Contractor License No.: Permit No.: 20160199 Issue Date: 5/0512016 (Work must be completed within 180 days) Phone: 253- 306 -2255 Owner: Lot: Phone: Expires: Project Information: Project: UTILITY Description of Work: WORK IN ROW TO RELOCATE AN EXISTING POLE APRROX 10 FT NW OF THE CURRENT LOCATION. NO TRENCHING AND NO ASPHALT CUTS Sq. Ft. per floor: First Heat Type (Electric, Gas, Other): Second Third Garage Basement Fees: Item RIGHT OF WAY Contractor PUGET SOUND ENERGY TOTAL FEES: Appocant's Affidavit: I ce ify that I have read and examined the information contained within the application and know the same to b true anVS� o certify that the proposed structure is in conformity with all applicable City of Yel regulati e governing zoning and land subdivision, and in addition, all covenants, eas ments a ecord. If applying a contractor, I furth er certify that I am currently regi tered in t Siana re Date 'S -vP s /l Firm 7 v l�- Fees $ 125.00 $ 125.00 OFFICIAL USE ONLY # Sets of Prints: Final Inspection: Date: By: City of Yelm Permit No. d lUi� 19 PUBLIC WORKS trenching/No asphalt cuts 901 Rhoton Rd NW Application to Perform Work on Yelm, WA 98597 Public Right of Way and /or Connect Phone: 360- 458 -8406 to Utilities FAX: 360 - 458 -8417 Name: Puget Sound Ener /Potelco INC APPLICATION The undersigned hereby makes application to: I'No Work in ROW to relocate an existing pole- approx. 10' N.W. of the current location. trenching/No asphalt cuts Location of work: 15624 Coates Rd. S.E. I agree to perform the work in strict compliance with Yelm Municipal Code, Chapter , the special conditions enumerated herein and the attached conditions I have read and will adhere to the general provisions applicable to permits contained on this form. The Public Works Department (360 -458 -8406) must be contacted for inspection 24 hours before work commences or this permit will be void, The Underground Utilities Coordinating Council (1- 800 - 424 -5555) must be contacted two (2) working days before proceeding with any excavation associated with this permit. Name: Puget Sound Ener /Potelco INC Address: 2711 Pacific Ave. S.E., Olympia, WA 98506 Phone: 253 306 -2255 Proposed starting date of instal latio : 05/16/16 Durati :2 days Date: 04/21/16 Signature: PERMIT REQUIREMENTS For Official Use Only Fee $ IZ Issued 7 l Fee Received $ IBS.— Application Approval Signature: Receipt Number po a3 o34 2 To Be Completed B City Permission is hereby granted to perform the above des ibex( work subject t theeneral provisio s contained on this form, and the followingspecial conditions: VA: - , ,� fit i r00 A bond in the amount of -- is required to insure compliance with the above conditions, refundable upon satisfactory completion of work. 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LL as �mmY�cic90 mvmi z J C� c< e_Swu~ia��cN7 M \ Lj / W � (n n w n rnz Xw� �wu� �w -on jw j = LLI �O waa��azz U) f-- a aa a z ¢wzz�m U) a o - w a Z d 9 0 w ° > LL a z a z 2 E E M u iii 4 U w 6n`P31V00132J 310d--'I-i .IAI 09SOBOSOL \OV-)\ ""'-i "IAI --ZP6 - 9M6 '6L AV City of Yolm (36 ) 458 -3244 REC #: 00230342 5/05/2016 12:29 PM OPER: CO TERM: 001 REF #: 827177 PAID BY: TRAN: 33.0000 BUILDING P(RMITS 20160199 125.000R PUGET SOUND ENERGY 15624 COATES RD SE ROW 125.00CR TENDERED: 125.00 ('HECK APPLIED: 125.00 - CHANGE: 0.00 Karen Bennett From: Ryan Johnstone Sent: Thursday, April 21, 2016 4:19 PM To: Karen Bennett Subject: FW: Yelm ROW permit app/ 101098227 / 15624 Coates Rd. S.E. Attachments: Yelm_101098227 app.pdf; Yelm_101098227 sketch.pdf Follow Up Flag: Follow up Flag Status: Flagged Categories: Red Category City of Yelm 901 Rhoton Rd. I Yelm, WA 98597 ryanj @ci.yelm.wa.us p:360- 458 -8406 From: Wattenberg, Sara [ mailto:sara.wattenberg @pse.com] Sent: Thursday, April 21, 2016 1:35 PM To: Ryan Johnstone Subject: Yelm ROW permit app/ 101098227 / 15624 Coates Rd. S.E. Hi Ryan, Attached please find the permit application for job # 101098227 at 15624 Coates Rd. S.E. I can't remember if I need to pre -pay for this. If so, can I pay by credit card? Please contact me with any questions. Thank you so much, Sara Wattenberg Permit Specialist Puget Sound Energy Cell: (253) 306 -2255/ Desk: (360) 570 -6890 Sara.wattenberg@pse.co