2014-14 ROW Permit 07152014 City 2014-14
t of Velm
Permit No.
Y
PUBLIC WORKS
901 Rhoton Rd NW
Application to Perform Work on
Yelm,WA 98597 Public Right of Way and/or Connect
Phone: 360-458-8406
FAX: 360-458-8417 to Utilities
APPLICATION
The undersi fined hereby stakes p IW lion to: n,
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b
oc ititrrt of work:
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conditions enumerated hc....-W,mm-��
agree p' i k in strict compliance
rein and the attached conditions d
P Municipal Code Chapter _ the specia
have. read and will adhere to theFgeneral provisions
�a t�rlicable to .errttits contained on this form.
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The Public Works Department(360 458-84U6) rtrit*rtmkrcwmcontactecl for iils section 24 bartrrs before work
contitltence. of this germitwill Ire void.
belore procecdin oath an excavation associatedlwiW �
' g Utilities Coordinating Council mutt be contacted two �
� Underground
o (?) working days
with this tcrrttit
Name. "� ,µ... ' I � Ld
Address t f •__. ° �t itc .. -......
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Propose l stai-tin date of installation:
Date.- Signature: - .. .. .. �.
74S
PERMIT REQUIREMENTS
Fee__ For Offici
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al Use Only
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Issued _m ...W _...._..w,� ....�.. �.• ....._..�,,._.�.. P_
Fee Deceived $ ..�.,� .....� �
Application Approval
Receipt Number Signature:.
Y p To Be Completed
granted to erform the above described w Cit
y � � work subject to the general provisions contained
Permission is hereby rat
on this lerrin, and the IbIlot.�in s social conditions:
A bond in the amount of _ is required to insure compliance with the above
conditions, refundable er tots satishicterr letion of work.
No work shall be done under this permit until the party or parties to whom it is granted shall have
communicated with and received instructions from:
l�erttrtrks:
FITS, Insp Inspector Final Project'
Date
Corttpletion A roval:
Date ec ion ..� _•
Revised 03/09/2011
GENERAL PROVISIONS APPLICABLE TO ALL PERMITS
In accepting this permit, the petitioner, his successor and assigns, agree to protect the CITY OF YELM,
WASHINGTON, and save it harmless from all claims, actions or damages of every kind and description which
may accrue to or be suffered by any person, or persons, corporation or property by reason ofthe performance of
any such work, character of materials used or manner of installation. maintenance and operation or by the
improper occupancy or rights of way or public structure and in case of any suit or action is brought against said
City for damages arising out of or by reason orany commencement of such action, defend the same at his or
their sole cost and e:spense and will satisfy any judgment after the said suit or action shall have finally been
determined Wadverse to the said City.
If the work done under this permit interferes in any way with the drainage of the area, the grantee shall wholly
and at his own expense make such provisions as the City may direct to correct said drainage problems.
Upon completion of said work herein contemplated, all rubbish and debris shall be immediately removed and
From the roadway and roadside shall be left in a neat and presentable condition that is satisfactory to the City.
The party or parties to whom this permit is issued shall maintain at his or their sole expense the structure or
object for which this permit is granted in a condition satisfactory to the CITY OF YELM.
The CITY OF YELM may revoke, annul, change, amend. anip ily, or termimt«rte this permit or any of the
conditions herein enumerated if grantee fails to co ntply %sitlt any or all of its provisrcrrts, requirements or
regulations as herein set forth or thru willful or unrctirsonable neglect, Bails to heed or comply with notices given
or if the utility herein granted is not installed, operated, and maintained in conliorrni�ty herewith or at all or for
any cause or reason whatsoever.
All work areas shall be adequately barricaded according to iN4lJ"fCD Standards. Barriers shall be properly
lighted at night.
All trenches shall be backfilled with selected backlill materials unless otherwise directed by the Engineer.
PAVEMENT REPLACEMENT: Asphalt pavement shall be replaced to a minimum depth of four(4) inches
thick or match to the existing pavement whichever depth is greater and to the dimensions specified by the
Engineer. In gravel alleys the permittee shall replace base and surface rock.
All work shall be conducted using current WISHA/OSHA regulations. Particular attention shall be paid to the
requirements as they pertain to work in trenches, electrical work, work in high places and to safety apparel such
as, hard hats and safety vests.
All work shall be completed to City Standards as set forth in the City of Yelm Development Guidelines, and
policies.
The PUBLIC WORKS DEPARTMENT office (360-458-8406) must be contacted for inspections 24 hours
before work commences.
Revised 03/09/2011
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Teriry Primle
From: wa @occinc.com
Sent: Tuesday,July 15, 2014 1:36 PM
To: TPRIMLEY @RBC-UTILITY.COM
Subject: Ticket: 14196530
***DO NOT REPLY TO THIS EMAIL***
Ticket No: 14196530 2 FULL BUSINESS DAYS
Send To: C_EMAIL Seq No: 809 Map Ref:
Transmit Date: 7/15/14 Time: 1:36 PM Op:orsusa
Original Call Date: 7/15/14 Time: 1:18 PM Op: webusr
Work to Begin Date: 7/18/14 Time: 12:00 AM
State: WA County:THURSTON Place: YELM
Address: Street: BALD HILLS ROAD SE
Nearest Intersecting Street: MORRIS ROAD
Twp; 17N Rng: 2E Sect-Qtr:30-SE-NE,29-SW-NW
Twp: Rng: Sect-Qtr:
Type of Work: INSTALL TELE MAINLINE
Location of Work:SITE STARTS IN THE NE CORNER OF THE INTERSECTION AT THE
EXISTING HAND HOLE
LOCATE SOUTH ACROSS BALD HILL ROAD,THEN CONTINUE SOUTH ON THE EAST SIDE OF
MORRIS ROAD FOR 2,000 FEET TO 110TH AVE,AT 110TH AVE LOCATE THE NORTH SIDE
OF 110TH EAST FOR 650 FEET TO THE EAST ENTRANCE INTO THE SCHOOL
Remarks:AREA IS MARKED IN WHITE PAINT
Nad: Lat: Lon: Zone:
Company : R B C Best Time: ANY
Contact Name:TERRY PRIMLEY Phone: (360)576-5359 Ext.: 233
Alt. Contact:TERRY CELL Phone: (360)606-7205
Work Being Done For: FAIRPOINT COMMUNICATIONS Additional Members:
CC7711 COMCAST CABLE (425)392-6412
PUGE10 PUGET SOUND ENERGY, ELECTRIC (888)728-9343
PUGG10 PUGET SOUND ENERGY GAS (888)728-9343
TCSSW01 THURSTON CO STORM &SURFC WTR (:36O)867µ2099
WSDOT10 WA DO°I` -OLYMPIC REGION (360)357-2647
YCOM01 FAIRPOINT COMMUNICATIONS 652 (360)458-7701.
YELM01 CITY OF YLLM (360)458-8410
Please click on the following link to verify and confirm that the area covered represents the correct and complete work
site area.
1
Robinson Brothers Construction, Inc.
«ate
6150 NE 137`h Avenue, Vancouver, WA 98682
i q Phone: (360) 576-5359 Fax: (360)576-7781
www.RBC-Utility.com
Fax Transmission Cover Sheet
Date: _
Attention: keU'A)
Fax #: . coo r Ise - S YO
From: ley
Fax #: 3d -5-26 - I I S,/
RE: Pa-k®t Fok
Message:
Communications Renewable Energy Electric Utilities