HomeMy WebLinkAboutPermit File 1220 34th Street Engineering and Development Services ,�t`O q
G1-Y o PO Box 547,Anacortes,WA 98221 4p� Q C%
�� TN: 360.293.1920 FAX 360.293.1938 'y
'i � EMAIL: engineering@cityofanacortes.org v n
' co RIGHT-OF-WAY PERMIT APPLICATION a Q
W RCW 19.122 Underground Utilities
r-. 4 CQ1;r CALL BEFORE YOU DIG -(800)424-5555 '4•pp• Q'
Applicant shall submit application 5 days prior to start of work and application shall include:
1) Payment of assessed fee
4:0(2) Drawing illustrating proposed work and its location. See checklist on
Page 2 of 2.
-CG 2026 or similar. City named as additional insured. Minimum$1,000,000 each
ccurrence,$2,000,000 general aggregate and$2,000,000 products-completed operations aggregate limit.
45 Proof of both state and city business licenses
❑ (5) Perfuri ante Bond—Construction cost x 150% before work begins
.7 (6) Encroaeent Agreement Required To be completed by City: ❑ Yes ❑ No
Site Address: City Approved Exemption ❑ Yes ❑ No
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�d/� 3 7 Age.0!°71,,„J[, EDEN���ASSIGNED P�W PERMIT UMBER:®��'yQ
Parcel No. 1
Owner Information (Required) Contractor Information (Required)
Name 1�� / / Name /
Address Address s,r-
/aZ 090 3 / S'/ /Z- Z� 34
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City City •4/V, �/
"d60' "(eCe / y/7Co`'fes,
J Phone c-V Y )6. 5� Phone 574/1i
Email A
// �` Email
Address (�/�Cd O/�i/S/t /�C avo5/ ° 447 Address 5'19
Work Includes (check all that fly)
❑ Curb_Cut ❑ Water_ Sewer ❑ Storm ❑ Street Cut ❑ Sidewalk ❑ Phone El
Describe Work to be Performed: (Notification of Utility Companies is Required)
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ity Approval Signature Date ton ,-'.
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By *nature below Applicant concurs that the Applicant shall defend, indemnify and hold the City, its officials, em- Kt r••a
ployees and volunteers harmless from any and all claims, injuries, damages, losses or suits including attorney fees, u▪`'n+ {r�
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arising out of or in connection with activities or operations performed by the Applicant or on the Applicant's behalf c1
out of issu ce of this Permit, a cept fir injuries and damages caused by the sole negligence of the City. ci c
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ta
pp' nature Date
Final Inspection Approval Signature Date I`
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NON- REFUNDABLE PERMIT FEE: (To Be Completed by City)
❑ Curb Cut $50.00
❑ Street Cut $50.00
❑ Inside Travel Way $50.00
❑ Outside Travel Way $20.00
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fewer Inspection Fee $50.00
❑ Sewer Re-Inspection Fee $25.00
TOTAL FEE ASSESSMENT $ ® ,�
A Site Plan (to scale) must be attached that include all of the following:
This checklist will aid the applicant in preparing a site plan. Permits that require installation of substantial improve-
ments may require plans drawn and designed by a licensed engineer. Please check with City staff prior to submit-
ting
your application.
• Draw the plan to a standard Engineering Scale[1"=10', 1"=20"etc.] on a minimum size sheet of 8'/x 11
and a maximum size of 11x17.
• Include the owners name,the parcel ID number,site address, north arrow, drawing scale and date.
• Include the contractor's name, address and phone number.
• Existing Right-of-Way lines, property lines, edge of pavement, curb/gutter, sidewalks, driveways and plant-
ing strips with dimensions between each.
• Adjoining street name(s)to the reference property.
• All existing public and private utilities in the area of the proposed project(Water, Sewer, Storm, Phone,TV,
Gas and Power), dimensioned to the edge of pavement, curb/gutter, sidewalk, driveways, planting strips.
• If applicable show easements, critical areas such as streams,wetlands and steep slopes.
• Proposed new construction.The proposed improvements shall be shown in heavier line type than the ex-
isting information
• Dimension the proposed new construction to the edge of pavement, curb/gutter, sidewalks, driveways,
planting strips, or another identifiable site feature that will help identify the proposed improvements in the
field.
• Erosion Control Plan.
• Traffic Control Plan per current MUTCD(See standard drawings at http://mutcd/fhwa.dot.gov). If the work
requires any lane or street closures,the City of Anacortes Public Works Inspector must be notified a mini-
mum of 48-hours prior to scheduled work for proper public notification by the City of Anacortes.
Work within the City Right-of-Way is permitted by approval of the City Engineer. All work in the right-of-way must be
bonded. The applicant and owner must use warning signs,traffic control, and barricades as necessary to ensure
public safety in the work area. The applicant and owner must restore the right-of-way to previous condition. Perma-
nent restoration may include overlays of portions of the right-of-way and restoration of landscaping which have been
disrupted by excavation work. The applicant and owner are liable for damage to public and private property.
Page 2 of 2
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rq' Anacortes Planning & Community Development Dept.
Permit Center
st.au"d"
� P.O.Box 547,Anacortes,WA 98221-0547 PH(360)293-1901
'woods: Ian Munce,Director • Edwin Frank,Building Official FAX(360)293-1938
April 6, 2006
Winston Thompson
PDA ProductionsC
1905 12th Streeett
Anacortes, WA 98221
RE: 1220 34th Street
Add a2nd Dwelling Unit
Dear Mr. Thompson,
Per our conversation April 5, 2006, this project will require installation of storm drainage, curb,
gutter, and sidewalk along that portion of the parcel fronting 34th Street. Contact Fred
Buckenmeyer for street and infrastructure requirements at 293-1920.
Sincerely,
CITY OF ACORTES
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Ed rank
Building Official
Cc. Fred Buckenmeyer, Assistant City Engineer
Don Measamer, Assistant Director of Planning
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City of Anacortes
Development Review Committee Application
Type of DRC meeting requested (check one):
General information meeting
,/Pre-application conference
Name: &re7 //"// Phone: fB/ -���d
Address: /ZL e 7 r C7 Fax
Project: %%;
• Location of Project: /y 2 0 Y7 i S7
Brief Description of Project(size, scope,etc.):
46Cd Se-c.o..eQ S>'-'c/C 6 eic% do te,4-yecc 2��,r�•,��C %d
eh-V-1I k G !mac l t
When all of the requited information has been received, City staff will schedule your DRC meeting
date. DRC meetings are held every Tuesday and generally start at 1:15 p.m. Representatives from
applicable City Departments will be in attendance. Due to the number of DRC meeting requests,
discussion will generally be limited to 30 minutes per project. However, if you feel you may require
additional time, please inform our office'so we may adjust the schedule accordingly. Lastly,we
request that ten (10) copies of the proposed drawings be provided.
*:a::•...:** *..*::::-.i::x*.... ...**::**-FOR OFFICE USE ONLY'<...':re..,.:. .:...,.:. . . .....:*s:t*>rn
THE MEETING HAS BEEN SCHEDULED FOR(DATE/TIME): ti/u/06 d'3 d
APPLICANT NOTIFIED BY(INITIALS/DATE): �� p
Distribute with Attachments to: CC/
Don Measamer,Building Steve Lange,Engineering
Dave Walde,Public Works Fred Buckenmeyer,Engineering
Marc Krueger,Operations Dan Harju,Fire
Rick Harvey, Operations Bob Clumpner,Engineering /
Adrian Moore,Water Mac Jackson,Operations 1 6ic ce r 5c
ttALast Updated April 4,2005
DRCAppRcaatinadoc
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