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A_4110 NE 4th ST
CiTYOFRENTONtyofRECEIVEDOCT142016DEPARTMENTOFCOMMUNITYANDECONOMICDVELOPMENTDEVELOPMENTDEVELOPMENTSERVICESDIVISIONSERVICESMASTERUSE/FRANCHISEUTILITYPERMITAPPLICATIONPhone:(475)430-7266Fax:(425)430-7231franchise@rentonwa.gov.....TOTHEAPPLICANT:Submit3copiesofplanswithapplication.Permitcostis$360.50.InspectionfeefOrtrenchingmorethan60linealfeetorinstallationof6ormorepoleswillbebilledat$60.00perhOüriSERVIGForCityUseOnlyCITYPERMITNO:MFPWORKORDERNO.:$7029DateofApplication:10-11-16FranchiseAgency:QwestCorpU/b/aCenturyLinkQCMailingAddressforPermit:2331566thAveS.Kent,WA.Zip:98032ContactName:a5V16\(bV’VSLV’Phone:260._JobNumber:N.J23618e-mail:_________________________________‘VC’\(tWiOVV1SDIJobSiteAddress:4110NE4thStProjectName:DescriptionofWork:AccessMH-642&MH-407tosplice&placefiberinexistingconduittoPSEriserpole,overlashnewaerialfiberandplacefiberinexistingconduit.Nosurfacedisturbance.Seeattached.381’aer,cQ.Pleasecheckallthatapply:NewConstructionLIRepair/RelocateIUndergroundOverheadLISidewalkLIStreetLIOpentrenchLIBoreLI#offeet:LIGasLIElectricOther:phoneEstimatedJobcompletiondate:11-7-16Contractorname:NorthSkyCommunicationsPhone:3602546920CityofRentonBusinessLicenseNumber:_BL.028638__StateContractorsLicenseNumber:_NQRTHSC857Q4“icertifythatiamtheapplicant’sownerorauthorizedagentanddoherebyagreetoabidetothetermsandconditionssetforthunderthispermiandshallcomplywiththeCityofRenton’sTrenchRestorationandStreetOverlayRequirements.”SignatureV?Date1o4ii6—T]CITYINSPECTORSHALLBENOTIFIED24HOURSPRIORCOMMENCEMENTOFALLWORKBYCALLINGTHEINSPECTIONLINEAT425-430-7203Jobsarerequiredtobecalledinforjobstart,re-inspectionandprojectfinal.__________________________________________LIApprovedasSubmittedPlanReview/DevelopmentServicesDateLIOn-SitePre-ConRequiredLIApprovedwithCommentsorRedlines______________________________________________ETrafficControlPlanAttachedUtilityInspectorDateLICameraInspectionofUtilitiesRequired______________________________________________IssueDate:________________________PublicWorksPermitSupervisorDatePermitexpires6monthsfromissuedate2/13 TRAFFICCONTROLPLANPROJECTNAME:N.123618PERMIT#_____________CONSTRUCTIONCOMPANY:NorthSkyCommunicationsPHONE#:360254-6920CONTACTNAME:Tonna.BarusoPHONE#:253372-5360ADDRESS:2331566thAveSKent,WA.98032CELL#:______________E-MAILADDRESS:TnnnRriisnr.ntiirylinkr.nmFAX#:253372-5176PROJECTLOCATION:4110NE4thStN/E/S/WOF:_________________WORKTIME:_________________________________APPROVEDBY:__________________WORKDATE:______________________________APPROVALDATE:__________________PermitHolderagreestoallthefollowing:•ComplywithalltrafficregulationsoftheCityofRentonandtheStateofWashington.•PrepareatrafficcontrolplanandobtainCityapprovalofthatplan.Thatplanshallbeimplementedforallstreetandlaneclosures,andtheplanshallbeperformedincompliancewiththeManualonUniformTrafficControlDevices.•Notifyemergencyservices(253-852-2121)twenty-four(24)hoursbeforeanystreetorlaneclosures.•Anylaneorstreetclosuresnotinconformancewiththeapprovedtrafficcontrolplanand/orwithoutnotificationofemergencyservicesmayresultinreceivingacitationforviolationofR.C.W.47.36.200through47.36.220,9A.36.050RecklessEndangerment,andotherapplicableStateandCitycodes.•IndemnifyandholdharmlesstheCityofRentonfromanyandallclaims,actions,andjudgments,includingallcostsofdefenseandattorney’sfeesincurredindefendingagainstsame,arisingfromandrelatedtoimplementationoftheapprovedtrafficcontrolplansincludingclaimsarisingfromtowingofprivatevehiclesandtheactsofthePermitHolder’sagentsandemployees.•TheCityofRentonshallbeentitled,initsreasonablediscretion,tosettleclaimspriortosuitorjudgment,andinsucheventshallindemnifyandholdharmlesstheCityforanysuchclaimspaid,includingtheCity’sreasonableattorney’sfeesandlitigationcostsincurredresultingfromsuchclaim.•IntheeventanyclaimorsuitisbroughtagainstCitywithinthescopeofthisAgreement,PermitHolderwillpayforlegalcounselchosenbytheCitytodefendagainstsame.•FlaggerandsignplacementaresubjecttorevisionbytheCityInspectoronsite,ifneededtoaddresstrafficorpedestriansafetyortravel.•Bymysignatureherein,Iacknowledgealltheaboverequirements.PRINTNAME:SIGNATURE:TonnaBarusoDATE:10-11-16DnLL3OOFFICECOPYTCONTRACTORDEV.SERVICE,INSPECTIONP.MILLERDEV.SERVICE,PLANREVIEWB.BANNWARTHPOLICECHARLESKARLEWICZFIREFIREMARSHALLFS#13 NOTES:•WorkZoneTrafficControlshallbeinaccordancewiththeManualonUniformTrafficControlDevices(MUTCD)andshownbysketchorreferencetoWSDOT.•TheplanmustbesubmittedtotheCity’sPW/TransportationDivisionforreviewand/orapprovalatleastthreeworkingdayspriortowork.•ApprovedTemporaryTrafficControlPlanmustbeattheworksiteduringworkhours.•ContractororentitymustcallRentonSchoolDistrict(425-204-4455)oranypublic/privateagencytobeaffectedbyatemporarylaneorroadclosure.•Completeassistanceandaccommodationshallbeprovidedtoallkindsofpedestriantrafficwhensidewalkorwalkwayisimpeded.•Totalroadclosurelastingmorethan24hoursissubjecttotheapprovalbytheCityCouncil.•Anyvehicle,equipment,barricade,orportabletow-awaysignusedwithintheworkareamustdisplayacompanylogooranylegallyacceptablesignshowingthecompanyname,address,andtelephonenumberataconspicuousplaceonthevehicleorequipment.InthecaseofTemporaryNoParkingZones,allthefollowingapplyinadditiontoprevious:•ContractormustcompleteformtoshowlimitsofTemporaryNoParkingZoneidentifyingbarricadelocationsforvacateparkingorcurblaneusage.•ContractormustpostnoticeofdatesandtimeofTemporaryNoParkingZonewithatleasttwosignsperblock72hoursinadvanceofeffectivedateandtime.•ThecoversheetofthisTrafficControlPlanformmustbeattachedtoeachTemporaryNoParkingSignontheprojectsite.•Temporarytrafficcontroldevicesmustberemovedimmediatelywhenworkisdoneornoconstructionactivitiesaregoingon.Ifdeemedabandoned,CitycrewswillremoveandstorethemattheCity’smaintenanceshop(3555NE2ndStreet).SKETCH--NORTH--