20160284 ROW Permit 07112016�f 4
City of Yelm "4"
PUBLIC WORKS OV
901 Rhoton Rd
Yelm, WA 9 7
Phone: 360-458 -
FAX: 360 - 458 -8417
Permit No. __am Q-U4
Application to Perform Work on
Public Right of Way and /or Connect
to Utilities
r APPLICATION
The undersigned hereby makes application to: Work in ROW to instal 127' of gas main.
No as.12halt cut Trench- 10' in soft surface ROW
job # 107051795
Location of work: 15624 Coats
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. ] m is WA 98506 Phone: 253 306 -2255
Proposed starting date of installation: Duration: I day
Date: 2
Signature:
PERMIT REQUIREMENTS
For Official Use Only
Fee $ Irp5 AO
Issued
Fee Received $* ,s P0
Application Approval
Signature:
Receipt Number 2 to 5 C7
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:
e- V17 ` Gr
A bond in the amount of is required to insure compliance with the above
conditions, refundable upon satisfactory 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
Completion Approval:
Date:
Revised 03/09/2011
p
City of Yelm
PUBLIC WORKS
901 Rhoton Rd
Yelm, WA 98 JIL70,00
Phone: 360-458 -
FAX: 360- 458 -8417
Permit No. ki? p b dW
Application to Perform Work on
Public Right of Way and /or Connect
to Utilities
APPLICATION
The undersigned hereby makes application to: Work in ROW to install 27' of gas main.
No as.12halt cut Trench- 10' in soft surface ROW
job # 107051795
Location of work: 15624 Coats Rd. .
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 9 506 Phone: 253 306 -2255
Proposed starting date of installation: Duration: l day
Date: 2
Signature:
PERMIT REQUIREMENTS I
For Official Use Only
Fee $ i 5 Au
Issued
Fee Received $* ,s P0
Application Approval
Signature:
Receipt Number 0002 (0 5 rj
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 completion of work.
No work shall be done under this permit until the part), or parties to whom it is granted shall have
communicated with and received instructions from:
Remarks:
First Inspection
Date:
Inspector Final Project
Completion Approval:
Date:
Revised 03/09/2011
• \• \�"�• v Oo��yb rf��i Get'
G
Olt
1y2
10
CHANNELIZATION
DEVICE SPACING
MPH
TAPER
TANGENT
55/70
40 0,
80
35 /45
3
60
25/30
20
40
Notes:
1. All signs and spacing to conform to the MUTCD
and Thurston County standards.
2. All sidewalks, driveways, exits and egresses
shall be completely clear unless otherwise indicated.
3. Channelizing devices are 28" traffic cones.
4. Sign size Gan be a minimum of 48" x 48" and
shall not obstruct pedestrian access.
5. Crew is required to leave a minimum of 11' for
traveling lane width.
6. Alert affected residents and businesses.
7. Work to take place between 9 a.m. and 4 p.m.
P01
AREA
UNDER
CONSTRUC71ON
�L3
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PUGET
SOUND
ENERGY
Job #105080560
15624 Coates Rd SE, Thurston Co., WA
June 13, 2016
Sheet 1 of 1 gregory.harwood@pse.com
(425) 424 -6425
Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 008997
Card Exp. 08/13/2019
g regory.harwood@ pse.COM
(425124 -6425
LEGEND
- 28' TRAFFIC CONE
® BORE PIT
TRAFFIC FLOW
TtFLAGGER
WORK VEHICLE
SIGN LOCATION
WARNING FLAG
Cl l f 58ell 44
(361 ) O
RECD''
OPEF', :
REF# :
PAID
00236859 7/11/2016
CO TERM: 001
829505
BY'.
TRAM: 33.0000
20160284
PUGET
15624
ROW
TENDERED:
F,PPLIED :
12:24 PM
BUILD1 OtCRITS
25
SOUND ENERGY OLYMPIA
COATES RD SE
125.00 CHECK
125.00-
r-" O
CHANGE:
City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: PUGET SOUND ENERGY OLYMPIA
Address: 2711 PACIFIC AVE SE
OLYMPIA WA 98506
Property Information:
Site Address: 1 -RR7d r0ATF-R Rn SF
Assessor Parcel No.: 22719230400
Contractor Information:
Name: PUGET SOUND ENERGY OLYMPIA
Address:
2711 PACIFIC AVE SE
OLYMPIA WA 98506
Permit No.: 20160284
Issue Date: 7/11/2016
(Work must be completed within 180 days)
Phone: 253 - 306 -2255
Owner:
Subdivision: TYLER TERRACE Lot: 2
Contractor License No.: Expires
Phone:
0 /00 /0000
Project Information:
Project: UTILITY
Description of Work: WORK IN ROW TO INSTALL 27 FT OF GAS MAIN. NO ASPHALT CUT. TRENCH 10 FT IN
SOFT SURFACE ROW. JOB #107051795
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
RIGHT OF WAY
Contractor
PUGET SOUND ENERGY OLYMPIA
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 re�trictionslo-f-r—eqprd. If applying as a contractor, I further certify that I am currently
registered in +Yhe S at of Wash' gton.
Signature Date �' I
Firm 0��> C--
Fees
$ 125.00
$ 125.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
✓Y
0 50' 100'
INSTALL 2" = 27'
JOINT 2" = 504'
2" CAP EOM/1MREBOX
534'NCL, 51 R'
( J'NCL, ( )R'
O
0
R50'
j I /
_
i
/
`r
1gfl'
f
[i�?
JOINT 2 "MPE -7,...
. 504'@ 29'ECL TO 5IR'
"@ l )'ECL TO ( )R'
/
,�0
,��•
Lomtion Size
N -S -E -W in
Type
Schad
Qty
each
from
Q /
�y
'A'
LOT 1
NO GAS 2
4
1
65
PRIMARY
ENGR - GAS
� O
O /
/
)'WCL
H
2" HVTT TE4N '55' y Y' POLYVALVElOPEN
BEGIN JT MAIN Y
( )'NCL, ( )'WCL `T �jq 30'NCL, 29 -ECL
/r
42'`1
SITE PLAN /S'a
a�
CROSSINGS (',0Nf)[ ]IT TAR[ F
X -ING
NO.
Location
GAS POWER
Length
ft
Remarks (type of crossing)
(primary, Feeder Secondary,
SL Li hl, Gas onl etc.,
Size
Type
sched
Qty
each
Lomtion Size
N -S -E -W in
Type
Schad
Qty
each
from
!o
X01
'A'
LOT 1
NO GAS 2
D8120
1
65
PRIMARY
PAw a
Pm »M Una
w Typlol EDin P W
Cub Sid I. WWh mry nary per zees, _
Nuroeref WAW �-
+I 1ZTypj' n4 Cmd,eL rs \ \\
F IGnd
iZ Moo
FielO ckal Sapendpn 3P
Laelgn .1 11 s.inJ / 11 Mn 1ZMW' pyr pe,ror
Wr«vPI is
Mu
6- er 1Z Moo Send sird:p - - - S or tZ Moo Ser4 Sfedin9 Ikpei
O.w GS -CaPpe 4on' Ovr POeer ,w Cmeemm'
4- Se,d Bee4kg r - Y
Gu�.. TVa TEL` P'r/ry -J `Samntlay
NOTES: Poeer Poxer
1. II III final 11 .111" contains racks gre- than D Inches in diameter, instiN 12 Inches compacted sand shading across the full width of the trench.
If the final be Mill contain¢ rocks a inches in dfamelf or smaller, install 6lnches compacted send shading across the full width of the trench.
2. Rocks greater than 10 inches damerer are not permitted In the final leaekfill.
3. Sand badQnq is requiretl under PSE gas pipe. Bedding is not required for the full width of the tench; it shall extend from the
Side of the trench nearest to where the ga s main /serdce is instilled to . nsmmum of 6 inches on the opposite side of the gas line.
A. Ulihoss shall not be stacked over to gas lire In the trench.
5. If coat utllitlea will be included in Me trench, please contact PSE or local paver comps cry directly for cleararoe requiremmta.
6. Red. ad .barer. of 4 inches between paler and co mmunicatien, must have approval of the communications cempen lees
• Attsmatves to full -width trench shadng require PSE appr -l.
JOINT TRENCH DETAIL
Primary 8 Secondary- Mainline Gas 8 Communications (NTS)
65 2" D8120 GREY PVC (ft)
2 = Total 2" PVC Plug Caps
FITTER'S CHECKLIST (CHISOK ro00- CO-TION)
❑ sps-ad 3uei am PE P9e Par GOS 2450.1400 end 2460,1500
Q ReviexN ero rompMd wtl,YC¢nhu.Nen rwlr.
C Raeordader si Inndas -lrs onontlur GO$ po GOS2500.1100.
❑ Cempead poM keulelun IrspcS¢n per GOS 2525.1200 ere 25251700.
❑ Lea lM vorR eru N e cYen eM eee roMean.
F.-'. spos-
Fennede Name (piae.dl
compeer': P.- os 0.4
4580 W11
GENERAL NOTES - GAS (JOINT TRENCH):
1. Excavator to contact Utilities Underground Location Center (One Call) 48 hours prior to construction, to two
working days prior to construction. 1- 800 - 424 -5555
2. Notify appropriate permitting agency prior to job start (see permit requirements).
3. Erosion and sediment control shall be per PSE Standard Practice 0150.3200 Techniques for Temporary Erosion
and Sediment Control and any additional local jurisdiction requirements.
4. Any change in route, pipe size/type, tie-in method or additional main footage must be approved by the
appropriate Engineer/Project Manager.
5. Complete "Exposed Pipe Condition Report" on all exposed existing Steel PSE Facilities.
Check box on report for wire box (Test Lead) installation.
6. Pipeline Markers and Warning Signs shall be installed and recorded by the Contractor per PSE Gas Operating
Standard 2525.2500.
7. To prevent accidental overpressure of adjoining systems, no two mains shall be connected, except as shown on
this design, unless approved by the appropriate Engineer/Project Manager.
B. System MAOP denoted by ISystemMAOP=60PSIG
9. Install Main Valves out of traffic where possible
10. Gauge (use Manometer for LP Systems) and monitor use of all stoppers and squeers to Insure adequate feed.
11. Install one pound Anode for every 1000' of locati g wire. Install Arcade and Test Lead Wires per PSE Gas
Operating Standards 2525.1200 and 2525.2300.
12. If STW pipe involved, coordinate installation with CP Tech. N/A Cell # NIA
13, Purge Points and Pressure Taps shall be installed per PSE Gas Operating Standards 2525.3400 and PSE Gas
Field Procedures Manual 0812 and 0813.
14. Mains and services shall be tested and purged per PSE Gas Operating Standards 2525.3300 and 2525.3400,
15. Unless otherwise noted:
All pipes Installed in plat to be 2" MPE -7.
All crossings to be Yellow 4" PVC.
All Services to be 1-1/8" PE.
/ dents service stub location.
�') denotes footage between fittings.
16. Customer to dig and backfll on pdvaW property or easement only. Trenches must conform to PSE Gas
Operating Standards 2525.1500, 2525.1600 and 2525.1700.
17. Note all recordable footages, cealions and material changes on the se -built in red.
18. Upon completion of the project send the print copy, along with the completed Work order, listing crew 8 actual
materials used to the appropriate deign group.
19. On site pre -con required before start of job.
20. At symbol: install natural gas main piping and fixtures. Size as indicated on tables and
Work sketch (gas main is to parallel power system unless otherwise shown on work sketch).
21. Inclement weather conditions may muse delays in construction times and dates.
Service Stub. NIA
S- ica/Meler NIA
Smvk:e/Mely NIA
ServicsiMeler NA
Ind Service NIA
Ind MSA NIA
01¢ Rs9. / FT N/A
HP SvrJMSA NIA
Relocate NIA
Retbement NIA
Prelect Manager Contact Information
Manager. Brian Hannon
Cell PdO°e 425 95 -5526 "•e f "T
Vicinity Map
N.T.S.
Owner / Developer Contact Info
Mountain Tamace S. W..
14730 Stale Route 507
YeM. WA 98507
ATTN: Mike KamOineM 380 -507 -0888 aR
For contact. below dal 1-8a 8-CAU. PSE (225.5773)
CALL (800) 4245555
2 BUSINESS DAYS BEFORE YOU DIG
-LO M Red. bed' Yea ® No ❑
'Fing ng Required' Ye. ® No D
REAL ESTATE/EASEMENT
REDT # (RW 408517)
PERMIT
THURSTON COUNTY
REV#
DATE
x.
DESCRIPTION
FUNCTION
CONTACT
PHONE NO
DATE
-
15e ^i
Ct.•x Afi St
-
PROJECT MGR
Bnan Harmon
425 -5528
2/10116
2
Owner / Developer Contact Info
Mountain Tamace S. W..
14730 Stale Route 507
YeM. WA 98507
ATTN: Mike KamOineM 380 -507 -0888 aR
For contact. below dal 1-8a 8-CAU. PSE (225.5773)
CALL (800) 4245555
2 BUSINESS DAYS BEFORE YOU DIG
-LO M Red. bed' Yea ® No ❑
'Fing ng Required' Ye. ® No D
REAL ESTATE/EASEMENT
REDT # (RW 408517)
PERMIT
THURSTON COUNTY
REV#
DATE
BY
DESCRIPTION
FUNCTION
CONTACT
PHONE NO
DATE
3
-
PROJECT MGR
Bnan Harmon
425 -5528
2/10116
2
ENGR - GAS
M. Cebenee
M-395 -6625
612116
1
DRAWN BY
M.CeWnaq
253 - 3968825
6/2116
CHECKED BY
COUNTY
THURSTON
Emr Sect GAS
40
WK CTR
CIONC
APPROVED BY
CP APPROVAL
N/A
N/A
NIA
114 SEC
SEC .W19- T17N -R02E
OP MAP PI-AT
280.044
MAP
282.044
MAPPING
JOINT FACILITIES ARRANGEMENTS
UTILITIES
COMCAST
CENTURLY LINK
RIGHT OF WAY
PSE PLANNER
CONTACT
DAVEFARCEY
WAYDE HOLMOUIar
SHAWN GRENINGER
WA
PHONE#
(M) 4135372s
(360)764-5912
(253)476.8450
WA
" PUGET Tyler Terrace
SOUND 2- MPE -7 GAS MAIN EXTENSION - 11 S/F LOTS
ENERGY 15824 Coat. Rd SE, Ydm, WA. 98597
DESIGNED BY PUGET SOUND ENERGY
SAP Sup Order Nd
1010517
E EC Orde Nvm e
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