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20170100 ROW Permit Pkg 01042017City of Yelm Permit No. LQ011,7010 PUBLIC WORKS West, placing 2" conduit with .625 coax cable. This work is being done to replace existing damaged conduit. 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: James Pierce APPLICATION The undersigned hereby makes application to: Directional Drill / Bore 56' under Coates Rd. from Tap PED on South side of Road to the North. Then bore 115' to the Medium PED to the West, placing 2" conduit with .625 coax cable. This work is being done to replace existing damaged conduit. Location of work: 401 Coates Rd SE, Yelm, WA 98597. JT #227335 1 agree to perform the work in strict compliance with Yelm Municipal Code, 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: James Pierce Address: 4610 Tacoma Ave, Sumner WA 98390 Phone: 253 -405 -6263 Proposed starting date of installation: 1420/1 7 Duration: 45 Days Date: 12/21/16 Signature: PERMIT REQUIREMENTS I For Official Use Only Fee $ �' "' Issued l Application Approval Signature: Fee Received $ Receipt Number a 552Q 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 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 1° C EEO II HE 3 M6. BY., City of Yelm Community Development Department Building Division Phone: (360) 458 -8407 Fax: (360) 458 -3144 Applicant: Name: COMCAST Address: 4610 TACOMA AVE SUMNER WA 98390 Property Information: Site Address: Ant r_nAT1 =C On QP Assessor Parcel No.: Contractor Information: Name: COMCAST Address: 4610 TACOMA AVE SUMNER WA 98390 Contractor License No.: Project Information: Project: UTILITY Description of Work: Permit No.: 20170100 Issue Date: 1/04/2017 (Work must be completed within 180 days) Phone: 253 - 370 -4209 Owner: Subdivision: Lot: Phone: Expires: 0 /00 /0000 DIRECTIONAL DRILL. BORE 56 FT UNDER COASTES RD FROM TAP PED ON S SIDE OF ROD TO THE N. THEN BORE 115 FT TO MEDIUM PED TO THE W PLACING 2 IN CONDUIT WITH 625 COAX CABLE. THIS WORK IS BEING DONE TO REPLACE EXISTING DAMAGED CONDUIT. Sq. Ft. per floor: First Second Third Garage Basement Fees: Item Contractor RIGHT OF WAY COMCAST Heat Type (Electric, Gas, Other): TOTAL FEES: Applicant' Affidavit: I certify th t 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 reg Iations i g those governing zoning and land subdivision, and in addition, all covenants, easements an restricti ns of record. If pplying as a contractor, I further certify that I am currently registered', in t State f Washington. Signature Date Firm d Fees $ 125.00 $ 125.00 OFFICIAL USE ONLY # Sets of Prints: Final Inspection: Date: By: Cite o-3244 f yell (3611 458 RIC!. 00255200 oloai CO 1110 REF& 56833 TERM: a01 12017 r:52 PM PA 1[, 8 y. 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