20160241 ROW Permit 06162016City of Yelm
PUBLIC WORKS
901 Rhoton Rd NW
Yelm, WA 98597
Phone: 360 - 458 -8406
FAX: 360 -458 -8417
Permit No. Ohl �w
Application to Perform Work on
Public Right of Way and /or Connect
to Utilities
APPLICATION
The undersigned hereby makes application to: Excavate buried hand hole on Za o long haul fiber,
Location of work:
appx 100 ft SW of Brighton Rd and appx 100 ft NW of bike path in the OPT Pipeline easement.
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
_a pplicable to permits contained on this form.
The Public Works Department (360 - 458 -8406) must be contacted for insaection 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: Za o, Bob Thoman Project Manager
Address: 22651 83rd Ave S, Kent, WA 98032 Phone: 360.771.7377
Proposed starting date of installation: asal2 Duration: < one da
Date: ,'1
Signature: R
PERMIT REQUIREMENTS '
-- For Offici Use Only
-
Fee $ ��--
Issued
Fee Received $ _
Applicati Approval
Signature:
Receipt Number J "j
To Be Completed By City
Permission is hereby granted to perform the above described work subject to the general provisions contained
on this form, and the following special conditions:
A bond in the amount of - is required to insure compliance with the above
conditions, refundable upon satisfacto completion 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:
Remarks:
First Inspection
Date: '-
Inspector Final Project
Comp letion A roval:
`
Date:
r"
Revised 03/09/2011
City of Yelm
Permit No. unkO 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
to Utilities
FAX: 360- 458 -8417
Name: Za o, Bob Thoman Project Manager
APPLICATION
The undersigned hereby makes application to: Excavate buried hand hole on Za o long haul fiber,
Location of work:
appx 100 ft SW of Brighton Rd and appx 100 ft NW of bike path in the OPL Pipeline easement.
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: Za o, Bob Thoman Project Manager
Address: 22651 83rd Ave S, Kent, WA 98032
Phone: 360.771.7377
Proposed starting date of installation: asap Duration: < one day
Date: 6/6/16
Signature: R Thoman
PERMIT REQUIREMENTS I
For Official Use Only
Fee $ JZ5. —
Issued
Fee Received $ "'
Application Approval
Signature:
Receipt Number %4J
To Be Completed By City
Permission is hereby granted to perform the above described work subject to the general provisions contained
on this form, and the following special conditions:
A bond in the amount of is required to insure compliance with the above
conditions, refundable upon satisfactory com 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:
Remarks:
First Inspection
Date:
Inspector Final Project
Com letion A royal:
Date:
Revised 03/09/201 1
City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: ZAYO
Address: 22651 83RD AVE S
KENT WA 98032
Property Information:
Site Address: RPl( -- -ITnK1 Dr%
Assessor Parcel No.:
Contractor Information:
Name: ZAYO
Address: BOB THOMAN
22651 83RD AVE S
KENT WA 98032
Contractor License No.:
Project Information:
Project: UTILITY
Description of Work:
Subdivision:
Permit No.: 20160241
Issue Date: 6/16/2016
(Work must be completed within 180 days)
Phone: 360- 771 -7377
Owner:
Phone:
Expires: 0 /00 /0000
Lot:
EXCAVATE BURIED HAND HOLE ON ZAYO ONG HAUL FIBER. APPROX 100 FT SW OF
BRIGHTON RD AND APPDX 100 FT NW OF THE BIKE PATH IN THE OPL PIPELINE
EASEMENT
Sq. Ft. per floor:
First
Second
Third
Garage
Basement
Fees:
Item
Contractor
RIGHT OF WAY
ZAYO
Heat Type (Electric, Gas, Other):
TOTAL FEES:
Applicant's Affidavit:
I certify that I have read and examined the information contained within the application and know the same
to be true and correct. I also certify that the proposed structure is in conformity with all applicable City of
Yelm regulations including those governing zoning and land subdivision, and in addition, all covenants,
easements and restrictions of record. If applying as a contractor, I further certify that I am currently
registered in thee of Washin n. /
Signature _ A Date
Firm
Fees
$ 125.00
$ 125.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
(361 of �o1m44
(36 )
REC#: 00234773 6/16/2016
OPER: CO TERM: 001
REF #': 181741
PAID BY:
TRAM: 33.0000
20160241
ZAYO
BRIGHTON
ROW
TENDERED
APPLIED:
9 :56 AM
BUILDING PERMITS
125.00CR
RU
125.000R
125.00 ('HECK
125.00-
CHANGE: 0 00
Karen Bennett
From: Ryan Johnstone
Sent: Monday, June 06, 2016 11:43 AM
To: Karen Bennett
Subject: FW: Application /notice of intent to work on franchised utility
Attachments: Rig htofWayUseApplication.pdf
Weil
From: Robert Thoman [mailto:robert.thoman @zayo.com]
Sent: Monday, June 06, 2016 9:00 AM
To: Ryan Johnstone; Chad Bedlington
Subject: Application /notice of intent to work on franchised utility
Greetings Ryan and Chad,
Our contact information was outdated and the city website does not show an exact process so I reach out to
you. Zayo currently owns and maintains the PFL /360 fiber long haul that runs through Yelm.
All hand holes that are not located in a paved surface are buried.
We need to get at a splice located in the OPL easement just west of Brighton, just north of the highway.
I have included the application from the website.
Can you guide this through processes and contact me as to fees and when we can commence.
Normally, the work I have to do in the splice case is a midnight operation but because of the location of the
hand hole in a residential neaighborhood, we will do this during the day as to not disturb our neighbors.
I look forward to hearing from you.
Regards,
:�)iiroject IIM a in age r :�Iadfic NN iirt h s t II Zayo liir u 11
55551 551rd Ave 5 ... Il(ein: WA 55055
550 ..7 71 .75.7.7
Karen Bennett
From:
Karen Bennett
Sent:
Thursday, June 16, 2016 10:08 AM
To:
'Ryan Johnstone'; Chad Bedlington
Subject:
ROW Permit Pkg for Brighton Rd
Attachments:
20160241 Permit Pkg 06162016.pdf
Here is your complete pkt w /payment advice. Ready for your review.. .
Have a great day guys.
Karen T. Bennett
105 Yelm Ave W
Yelm, WA 98597
(360)458 -3835
karenb (& ci. uelm. wa. us
YEL
wnsiiiwc c row
Karen Bennett
From: Karen Bennett
Sent: Thursday, June 16, 2016 12:54 PM
To: 'robert.thoman @zayo.com'
Subject: City of Yelm - Issued ROW Permit
Attachments: 20160241 ROW Permit 06162016.pdf
Per our earlier conversation, attached you will find signed ROW permit. Questions,
please give me a call.
Have a great day!!
Karen T. Bennett
1 o5 Yelm Ave W
Yelm, WA 98597
(36o)458 -3835
karenb (& ci. uelm. wa. us
a m
EMM
WR 511117 -4-