20160352 ROW Permit 10262016City of Yelm
PUBLIC WORKS
901 Rhoton Rd NW
Yelm, WA 98597
Phone: 360 -458 -8406
FAX: 360- 458 -8417
Permit No. 2"1 (j
Application to Perform Work on
Public Right of Way and /or Connect
to Utilities
APPLICATION
The undersigned hereby makes application to: Gas Main Extension Hoffman Short Plat
Digging to begin near north property line located @ 129'S C/L of Prairie Wind Ct SE & 28' W C/L of
Prairie Wind St SE. Trench south 5 onto private properly.
Location of work: 9405 Cullens Rd SE
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 Energy / InfraSource
Address: 3130 South 38th St, Tacoma WA 98409 Phone: 253- 476 -6037
Proposed starting date of installation: 11/15/16 1 Duration: 1 day
Date 0 11 1k.0
Signature: V rn c6p'2� 1
PERM EQUIREMENTS I
For Official Use Only
Fee
Issued All
Fee Received $ y,
Application Approval
Signature:
Receipt Number opt, 'j q (Q
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 followingspecial 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 party or parties to whom it is granted shall have
communicated with and received instructions from:
Remarks:
First Inspection
Date:
Inspector Final Project
Completion A roval:
Date:
Revised 03/09/2011
OCT 2 5 2016
BY. ....................
City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Permit No.: 20160352
Issue Date: 10/26/2016
(Work must be completed within 180 days)
Applicant:
Name: PUGET SOUND ENERGY Phone: 253 - 476 -6295
Address: 3130 S 38TH ST
TACOMA WA 98409
Property Information:
Site Address: 9405 CULLENS RD SE Owner:
Assessor Parcel No.: 21724110700 Subdivision: HOFFMAN PLAT
Contractor Information:
Name: PUGET SOUND ENERGY Phone:
Address:
3130 S 38TH ST
TACOMA WA 98409
Contractor License No.: Expires: 0 /00 /0000
Project Information:
Project: UTILITY
Description of Work: GAS MAIN EXTENSION, HOFFMAN SHORT PLAT. JOB NUMBER 107051806
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:
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 striction of record. If applying as a contractor, I further certify that I am currently
registered State of W shington.
Signatur AA
(y Date n'
Firm 0V
Lot:
Fees
$ 125.00
$ 125.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Cite of Yelm
(361) 458 -3244
REW 00247964 10/26/2016 9 :53 AM
OPER: CO TERM: 001
REF #: 834907
PAID BY:
TRAM: 33.0000 BUYING PERMI13
20160352
PUGET SOUND ENERGY
9405 CULLENS RD SE
ROW 125.00CR
TENDERED: 125.00 CHECK
APPLIED: 125.00 -
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0 1, 2'
0 50' 100'
JOINT 211 = 688 FT
JOINT 2" MPE -7
JOINT 2" MPE -7 95'
JOINT 2" MPE -7
SITE PLAN
SCALE: 1" = 50'
w- w wawa n Aft r- r%IAr T A sI C
� 12+00
1 {v -
NI I -- --- -- ?3&_:------ - - - - - --- L'z__
PRAIRIE WIND CT SE / t 5,506 f 2
LU .' M / / 1 t 1.1-145 ikons
(L r 1�- _ �/ _ - _ _ k net, m' :r : E
I I
236. 4 - - - -- - -
N I0 i 21' MPE IP 28'S
n� �� a� Zn T- - - - --
J
/
{I
{ I
FL L /PiJMP I
Yv'YSE -
f -
1
I `
DESCRIPTION
LOCATION
PIPE
DESIGN
AS -BUILT
OF
ACTIVITIES
FROM
TO LOT
SIZE
(IN)
TYPE
LENGTH
(F)
LOCATION
LENGTH
(FT)
EFV
SIZE
LOCATION
REMARKS
SS SINGLE
2" MAIN
1
1 1/8
MPE -7
10
( )SCL
3
2600
1
80
SS SINGLE
2" MAIN
2
11/8
MPE -7
10
( )SCL
60
2600
C. MCD NALD
253.395.6836
SS SINGLE
2" MAIN
3
1 1/8
MPE -7
10
( )SCL
PRESSURE
2600
GAS WK CTR
CIONC
TYPE TEST
SS SINGLE
2" MAIN
4
1 1/8
MPE -7
10
( )SCL
OP MAP
280.38
2600
DATE OFF
/ /
SS SINGLE
2" MAIN
5
1 1/8
MPE -7
10
( )ECL
TYPE TEST
2600
❑ AIR
❑ NITROGEN
SS SINGLE
2" MAIN
6
11/8
MPE -7
10
( )ECL
/ /
2600
MARILYN DANBY
-
SS SINGLE
2" MAIN
7
11/8
MPE -7
10
( )ECL
DESIGN PRESSI 60
2600
2023 03/10
SS SINGLE
2" MAIN
8
11/8
MPE -7
10
( )ECL
2600
SS SINGLE
2" MAIN
9
11/8
MPE -7
10
( )ECL
2600
SS SINGLE
2" MAIN
10
11/8
MPE -7
10
( JECL
2600
SS SINGLE
2" MAIN
11
11/8
MPE -7
10
( )ECL
2600
SS SINGLE
2" MAIN
12
1 1/8
MPE -7
10
{ )ECL
2600
SS SINGLE
2" MAIN
13
"M
MPE -7
10
( )ECL
2600
SS SINGLE
2" MAIN
14
11/8
MPE -7
10
( )ECL
2600
SS SINGLE
2" MAIN
15
1 1/8
MPE -7
10
( )ECL
2600
SS SINGLES = 15
r0r10.C1A1dft_ d'_f%L1n111T TORI P
150 FT 1 1 /8" PE PIPE
X4NG
#
LOCATION
GAS
POWER
XING
LENGTH
TYPE OF CROSSING
(Feeder, Primary, SOcondary, etc.)
FROM
TO
SIZE
(IN) TYPE QTY LOCATION
SIZE
(IN)
TYPE
QTY
X01
LOT 2
LOT 5
4 40 1 N
2
DB120
2
1 80
GAS MAIN, PRIMARY
NIA
WA
3
DB120
1
80
SECONDARY
X02
LOT 10
1 "A"
3
DB120
1
60
SECONDARY
2" DB120 GREY PVG = SU F 1 Z- F'VL; VLUU QUA %'� = L
4" PVC PLUG /CAPS = 2 4" YELLOW SCH 40 PVC = 80 FT ,3" DB120 GREY PVC =140 FT 3" PVC PLUG /CAPS = 4
11;14 w a-d. - ..a+aer" * GM
R!W or
Property Line
Excavated
4ti" Typical Dirt Pile
Curb Sidewalk width may very per �4" Min
Number of utilities \\ kl',,�,\ 12" Typical and Conduits 4.s ` Finial Grade ,lr /l l /j /
�i \•r \ \i \�i;•` \fir \ \i \ \i; �i \ \\i \ \i \�i,��i \ \jf\ � �/ l
12" Min
Final Backrill�'Z ` Separation // Min Cover
Location of roof drain i 12" Min 12" Min ° /j Over Power
Intercept (depth varies). i 48"
^� Max
Depth
6' or 12" Min Sand Shading � % - - - - Y dPower�afte Compaction' Over Gas after Compaction �/ Over paces
4" Sand Bedding a
GasJ TV & TELJ Primary J I- Seconder/
NOTES: Power Power
1. If the final backfiII contains rocks greater than 8 inches in diameter, install 12 inches compacted sand shading across the full width of the trench.* If the final
backriiII contains rocks 8 inches In diameter or smaller, install 6 inches compacted sand shading across the full width Af the trench.
2. Rocks greater than 10 inches diameter are not permitted in the final badtfill.
3. Sand bedding is required under PSE gas pipe. Bedding is not required for the full width of the trench; it shall extend from -the side of the trench nearest to where
the gas main /service is installed to a minimum of 6 inches on the opposite side of the gas line.
4. Utilities shall not be stacked over the gas line in the trench.
5. If wet utilities will be included in the trench, please contact PSE or local power company directly for clearance requirements.
6. Reduced clearance of 4 inches between power and communication, must have approval of the communications Companies.
* Alternatives to full -width trench shading require PSE approval.
JOINT TRENCH DETAIL
NOT TO SCALE - PRIMARY AND SECONDARY - MAINLINE GAS COMMUNICATIONS
EROSION & SEDIMENT CONTROL REQUIREMENTS
EROSION & SEDIMENT CONTROL SHALL BE PER PSI= STANDARD PRACTICE
0150.3200 TECHNIQUES FOR TEMPORARY EROSION & SEDIMENT CONTROL
& ANY ADDITIONAL LOCAL JURISDICTION REQUIREMENTS.
(LOCAL JURISDICTIONS MAY HAVE ADDITIONAL REQUIREMENTS INCLUDING
NOTES DETAILING WHERE EROSION OR SEDIMENT CONTROL STRUCTURES
ARE TO BE INSTALLED, CROSS SECTION DETAILS OF THE TYPICAL EROSION
STRUCTURES, & SPECIAL REQUIREMENTS FOR WORK IN SENSITIVE AREAS.)
FITTER'S CHECKLIST (CHECK BOX To tcONFIRM COMPLETK"
❑ Inspected Steel and PE pipe per GOS 2450.114 and 2450.1500
❑ Reviewed and complied with all construction ncA95•
❑ Recorded all required information on the as -builk per GOS 2500.1700.
❑ Completed post installation inspection per G0.o 2525.1200 and 25252700.
❑ Left the work area in a clean and safe oonditlonn•
Foreman's Signature
Foreman's Name (printed)
Company: Poteloo Inc Date
cr IL'.._fii
56' ROW
W
25.5' 30.5'
5' 1 3 19.5' 19.5' 6' 5'
r SIDEWALK R - r PLA TM SIDEWALK
ASPHALT ASPHALT
EXIST 2" MPE IP 28' WCL
2" MPE IP -
CROSS SECTION - PRAIRIE WIND ST SE
SCALE: NONE LOOKING NORTH
MY ROW
N 25.5 30.5'
6' 18.5' 18.5' 6' 5'
i
PLANTER PLANTER SIDEWALK
1' rL 1'�
ASPHALT I ASPHALT
CROSS SECTION - ROAD A
SCALE: NONE
LOOKING EAST
E
GENERAL NOTES - GAS (JOINT TRENCH }:
1. Excavator to contact Utilities Underground Location Center (One -Calq 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 (rest 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.
8. System MAOP denoted by I System MAOP = 60 PSIG
9. Install Main Valves out of traffic where possible.
10. Gauge (use Manometer for LP Systems) and monitor use of all stoppers and squeezes to insure adequate feed.
11. Install one pound Anode for every 1000' of locating wire. Install Anode and Test Lead Wires per PSE Gas
Operating Standards 2525.1200 and 2525.2300.
12. If STW pipe involved, coordinate installation with CP Tech. NIA 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.
/ denotes service stub location.
L_i denotes footage between fittings.
16. Customer to dig and backfill on private property or easement only. Trenches must conform to PSE Gas
Operating Standards 2525.1500, 2525.1600 and 2525.1700.
17. Note all recordable footages, locations and material changes on the as -built in red.
18. Upon completion of the project send the print copy, along with the completed work order, listing crew & actual
materials used to the appropriate design 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 cause delays in construction times and dates.
GAS MAIN INSTALLATIONIRETIREMENT
Notification #
Type/Work
Pipe Size
Type
Est Length
Act Lglh
Manufacturer
WA
NIA
WA
N/A
NIA
NIA
JOINT
2"
MPE -7
688 FT
N/A
NIA
NIA
NIA
WA
NIA
NIA
NIA
ENGR - GAS
C. MCDONALD
253.395.6638
9.16.16
1
DRAWN BY
C. MCD NALD
253.395.6836
9.16.16
CHECKED BY
GAS MAIN
PRESSURE
& TESTING
GAS WK CTR
CIONC
TYPE TEST
❑ SOAP
❑ AIR
❑ NITROGEN
❑ WATER
DATE ON
/ /
START TIME
OP MAP
280.38
TESTED BY
DATE OFF
/ /
STOP TIME
MAPPING
PRESSURE
TEST RESULTS
OP ❑ F
TYPE TEST
❑ SOAP
❑ AIR
❑ NITROGEN
❑ WATER
DATE ON
/ /
START TIME
CENTURYLINK
TESTED BY
DATE OFF
/ /
STOP TIME
MARILYN DANBY
-
PRESSURE
360.357.1230
TEST RESULTS
OP ❑ F
❑ TESTED BY PSE PRESSURE
CONTROL, SEE FORM 1928
DESIGN PRESSI 60
1 SYS MAOP 1 344.60
2023 03/10
PROJECT PHASE
Notification #
Order #
GAS SAP Superior
Service Stubs
Service /Meter
Service/Meter
Service /Meter
Ind. Service
Ind. MSA
Dis. Reg. / FT
HP Svc/MSA
Relocate
Retirement
502846571
107051806
WA
106308784
WA
NIA
WA
N/A
NIA
NIA
NIA
NIA
WA
N/A
N/A
NIA
NIA
NIA
WA
NIA
NIA
NIA
IIIIIIIIIII .•.� �•. ��... C� -yl,�. �*.y ��.�,
Project Manager Contact Million. Ion:
Manager. Brian Hannon
Cell Phone. 425.495.5528
E -Mail: Brain.HarmondMee.com
Vicinity Map
NOT TO SCALE
EMAIL CONTACT. BOWEN CONSTRUCTIONQMSN.COM
Owner / Developer Contact Info
Bowen Construction
PO Box 42
Buckley, WA 98321
ATTN: Brian Bowen 253.208.9412 office
O
w
0
00
0
00
.Is
0
v'
rn
For contacts below dial 1-888 -CALL PSE (225 -6773)
CALL (800) 424 -55W
2 BUSINESS DAYS BEFORE YOU DIG
THIS SKETCH NOT TO BE RELIED UPON FOR EXACT LOCATION OF EXISTING FACILITIES
"Locates Required' Yes M No ❑
"Flagging Required" Yes ® No ❑
REAL ESTATE/EASEMENT
REDT # (RW -096653)
PERMIT
CITY OF YELM
REV#
DATE
BY
DESCRIPTION
FUNCTION
CONTACT
PHONE NO
DATE
3
PROJECT MGR
Brian Harmon
425.495.5528
6.14.16
2
ENGR - GAS
C. MCDONALD
253.395.6638
9.16.16
1
DRAWN BY
C. MCD NALD
253.395.6836
9.16.16
CHECKED BY
COUNTY
Thurston
Emer Sec
49
GAS WK CTR
CIONC
APPROVED BY
N/A
CP APPROVAL
N/A
IN/A
114 SEC
NE Sec 24 T11 7N R01
OP MAP
280.38
PLAT MAP
282.043
MAPPING
JOINT FACILITIES ARRANGEMENTS
UTILITIES
CONTACT
PHONE#
COMCAST
CENTURYLINK
PSE RIGHT OF WAY
-
TODD ZIMNY
MARK TORRES
MARILYN DANBY
-
360. 357 .1234•
360.357.1230
253.476.6451
-
PUGU HOFFMAN SHORT PLAT
SOUND 2" MPE -7 GAS MAIN EXTENSION -15 S/F LOTS
1* A r F p11,V l er/
E1Y 9405 CULLENS ROAD SE, YELM, WA 98597
DESIGNED BY PUGET SOUND ENERGY
SAP Sup Order Nbr
107051606
ELEC Order Number
105080845
SCALE PAGE
a V = 50' 1 OF 1