20170313 ROW Permit Pkg 09112017City of Yelm
Permit No. 6d1 V1170-3) X3
PUBLIC WORKS
Asphalt cut- 3'x4'
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: Sara Wattenberg on behalf of Puget Sound Energy /InfraSource
APPLICATION
The undersigned hereby makes application to:
Work in ROW to cut & cap existing 1/2" main.
Asphalt cut- 3'x4'
t l 1
Location of work:
202 Solberg St. S.W.
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: Sara Wattenberg on behalf of Puget Sound Energy /InfraSource
Address: 2711 Pacific Ave. S.E., Olympia, WA 98501
Phone: (253) 306 -2255
Proposed starting date of installation: ZS
Duration: 5 Days
Date: ` -,74 1�
Signature:
PERMIT REQUIREMENTS '
For Official Use Only
Fee $
Issued
Fee Received $ a
Application Approval
Signature:
Receipt Number 0og
To Be Completed By ity
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 ,lJ 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
Com letion Approval:
Date:
Revised 03/09/2011
Applicant:
City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Permit No.: 20170313
Issue Date: 9/11/2017
(Work must be completed within 180 days)
Name: PUGET SOUND ENERGY OLYMPIA
Phone: 253 - 306 -2255
Address: 2711 PACIFIC AVE SE
OLYMPIA WA 98506
Property Information:
Site Address: 202 SOLBERG ST SW
Owner:
Assessor Parcel No.: 75300500100
Subdivision: Lot:
Contractor Information:
Name: PUGET SOUND ENERGY OLYMPIA
Phone:
Address:
2711 PACIFIC AVE SE
OLYMPIA WA 98506
Contractor License No.:
Expires: 0 /00 /0000
Project Information:
Project: UTILITY
Description of Work: WORK ON ROW TO CUT AND CAP EXISTING 1/2 INCH MAIN. ASPHAL CUT 3 FT BY 4 FT
Sq. Ft. per floor:
Heat Type (Electric, Gas, Other):
First
Second
Third
Garage
Basement
Fees:
Item
RIGHT OF WAY
Contractor
PUGET SOUND ENERGY OLYMPIA
TOTAL FEES:
Applicant's Affidavit:
certify that I have read and examined the information contained within the application and know the same
to be truJ?anA no orrect. I also certify that the proposed structure is in conformity with all applicable City of
Yelm reg s- inctuding those governing zoning and land subdivision, and in addition, all covenants,
Basemen restrictions of record. If applying as a contractor, I further certify that I am currently
reqistere e State of.Washington. n
• , , '•iS � � it li,�._._�
Fees
$ 125.00
$ 125.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
p^ °� U°1 N
�[ U
(3§D| yM�) 458-3244
RECA: 00280923 9/11/2017 12:34 PM
OPAP: CO TERM: 007
REFA: 851459
PAID BY:
TRAN: 33.0000 BUILDING PLRMI13
20170313 125.UKCR
PUG[T SOUND ENERGY (LYNFIA
202 GOLBERG ST 3N
ROW 175.O(CA
TENDERED: 175.00 (HECK
APPLIED: 125.00-
CHANGE: O.O�
A
CHANNELIZATION
DEVICE SPACING
MPH
TAPER
TANGENT
55/70
40
80
35/45
30
60
25/30
20
40
PUGET
' SOUND
ENERGY
Job# 108599739
202 Solberg St SW, Yelm, WA
August 24th, 2017
Sheet 1 of 1 everett.walker -paul @pse.com
(253) 625 -0964
Puget Sound Energy
Traffic Control Supervisor.
Gregory Harwood
Card No. 008997
Card Exp. 08/13/2019
gregory.harwood@pse.com
(425)424 -6425
Notes:
1. All signs and spacing to conform to the MUTCD
and City of Yelm 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 can 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.
8. Work area will be 18'S of C/L of Washington Ave SW
& 68' E of C/L of Solberg St SW.
Puget Sound Energy Gas Pre - Inspect Form
Job #:
108599739
Date:
8115/17
Address:
Jurisdiction:
YELM
City /Zip:
ROW Permit:
Yes
Customer:
Est. Start Date:
9/25/17
PM / Inspector
Est. Duration:
112 Day
202 SOLBERT ST SW
YELM, 98597
STEVEN HOWARD (253) 377 -2576
LUTHER RIMORIN (253) 278 -1118
Job Description / Scope of Work
CUT & CAP EXISTING 1/2" STW @ MAIN. NO FUTURE RECONNECT HERE. 1" STW IP GAS MAIN,
New Construction:
No
18'S, WHICH PUTS IT UNDER HARD SURFACE
(ASPHALT). 1 CUT TO GET TO MAIN. PM
/LUTHER
Construction Method
RIMORIN 253 - 278 -1118
PLAT Map: 283.043
t
~`
1
1 /2' STW -U
1969
203 2DO MIRE lJ 2�
,I
106
C-D'�
202
f
;! 1 /2'STW
5/8" MPE
2005-E 409
1967
,tip
416
413
!
� 1997MPE
l
r!
A 1
A
Work Location
Size of Cut
Surface Type
200'
West
I of CL
IOFSOLBERGST
&
I of CL
JONYELMAVE
3 "X4"
ASPHALT
of CL
I
&
of CL
of CL
I
&
I of CL
Service Information
Street Information
Job Type
Diameter:
0
Flaggers #:
Arterial:
No
EFV:
0
Police #:
TCP:
Yes
PUGET
ENERGY
Meter:
Speed Limit:
No Parks #:
Meter Loc:
Trolley Lines:
Mtr Hoods #:
Del Press:
Traffic Signal:
Bus Stop:
Bollards:
2.5" # 4" #
ADA Ramps #:
Route #'s: