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CONSTRUCTION PERM IT APPLICATION
Com m unity&Econom is Developm ent
City of Arlington • 18204 59th Avenue NE • Arlington,WA 98223 • Phone(360) 403-3551
CIVIL(TYPE I) GRADING/PAVING/DRAINAGE(TYPE II) RIGHT OF WAY(TYPE III)
TYPE I&II ONLY NEW DEVELOPM ENT REDEVELOPM ENT
Project Name CO IVCAST - JB0002383977 - REVISIO N
Snohomish County Tax Parcel I.D.#: 31051400302400
Project Address/Location: 19405 68TH DR NE
Description of Project: 'STARTING WITH VAULT 1, BO FE AND PULL 1,040' NW TO VAULT 3. CO NTINL
OWNER
Nam e
Address:
City: State: Z i : P hone:
Em oil:
APPLICANT
Name CO M (AST - JANDE BAIN
Address:1701 JO I-N F KENNEDY BLVD
city: PHILADELPHIA State: PA i : 19103 hone: 9713525392
Em oil: WACO N3TRUCTIO N JO NTUSE@CO M(AST.CO M
ENGINEER
Nam e
Address:
City: State: Z ip: P hone:
Em il: License#: E xpiration:
CONTRACTOR
Name CABLECO MLLC- LEAH IHLENFELDT
Address: 1429 AVENUE D #339
city: SNO HD M$H State: VVA i : 90290 3 hone: 60-965-5085
Email: SNO HD M$H.PERM TTING @ (ABLEC( License#: Q> BLEL*971 DP x iration: 8-21-2025
1, hereby certify that I have read and exam fined this application, City of Arlington M unicipal Code, Standard Plan & Specifications. Performance of the
proposed w a-k shall follow all applicable law sand regulations.The ow rer/applicant shall assum efull and com Ilete responsibility for said w a-k and shall
be responsible for the acquisition and com Oiance of all applicable perm is and/or authorizations w Hch m ay include, but not lim ted to, Right of Way
Perm t,WSDW Hydraulic Project Approval(HPA),WSDOE Notice of Intent(NOI),National Pollutant Discharge Elim iration System(NPDES),Arm yCorp.of
Engineers Perm is,the r uirements of the Endangered Species Act,and the Forest Practices Application(FPA).
Signature 5Cz;f,
Print Name JAN BAIN Date: 2/11/26
Pagel of 2 REV11/2021
Com plete package constitutes all item s Only com plete subm ktals w it be accepted.
Civil-Submittal Requirements.Type I: Electronic files shall be PDF on USB flash-drive,ern dl,or drop-box
❑ Com plete Application
❑ Construction Plans including cut/fill quantities
■ 2 full size plan sets 22"x 34"
■ PDF file of the com plete plan set
■ 2 full size set of landscape plans 22"x 34"
❑ M aysville Utility plans,if applicable(2 sets)
❑ Drainage Analysis including calculations and dow rstream analysis (2 sets)and(PDF file);refer to Storm w der Drainage
Requirements
❑ Geotechnical Report(2 sets)and(PDF file)
❑ SEPA is required if 500 or m ore cubic yards of cut/fill is proposed(not required if included w th a Land Use Perm t);if
there is not a Land Use Perm it associated w th the project,Public Notice M aterials w 11 be required
❑ G rading cut/fill quantity:
❑ Design Vehicle-dem onstrate turning radius include 45'Fire truck,dual axle,256-inch w beelbase
❑ Drafts of easem ent(s) dedication(s),and/or CAPE(s)for review
❑ Flood Hazard Perm t Application and required docum artation if project is w thin 100-year flood plain;refer to Flood
Hazard guidance documents
❑ Construction Calculation Worksheet
❑ NPDES Perm t(if required);See Storm Water Drainage Report,New or Redevelopm mt Flowcharts
❑ Assurance Device w 11 be required prior to Perm i Issuance(Bond or Assignm art of Funds)
❑ Perm t Fee due at tim eof perm t subm ital
Grading I Paving I Drainage Subm ittal Requirem ents.Type II:Electronic files shall be PDF on USB flash-drive,em dl,or drop-box
❑ Com plete Application
❑ Construction Plans including im port/export quantities
■ 2 full size plan sets 22"x 34"
■ PDF file of the com plete plan set
❑ Drainage Analysis including calculations and dow rstream analysis(2 sets)and(PDF file); refer to Storm w der Drainage
Requirements
❑ Geotechnical Report(2 sets)and(PDF file)
❑ SEPA is required if 500 or m ore cubic yards of cut/fill is proposed(not required if included w th a Land Use Perm t)
❑ SEPA Public Notice M aterial Requirements:
■ Snohom ish County Assessor's Quarter Section M ap: ❑ Show Subject Property ❑ Show 500 ft.Boundary
■ Current Ow rer List(of properties w thin 500ft.radius)including the follow ng:
❑ Tax Parcel ID Num ber(s) ❑ Ow mr(s)Full Nam e(s) ❑ Ow rer(s) M ailing Address(es)
❑ Current Resident&Property Address (if property ow rer doesn't reside at the property)
■ M ailing M aterial: Provide❑ w lite,#10 envelopes w th the follow hg affixed to the envelopes:
❑ Postage ❑ M ailing Labels ❑ Return Address labels: 18204 591h Ave NE,Arlington WA 98223
❑ G rading cut/fill quantity:
❑ Construction Calculation Worksheet
❑ N PDES Perm t(if required);See Storm Water Drainage Report,New or Redevelopm eft Flowcharts
❑ Perm t fee due at tim eof perm t subm ital
Right of Way Subm ittal Requirem ents.Type III: Electronic files shall be PDF on USB flash-drive,ern dl,or drop-box
❑ Com plete Application.
❑ Construction Plans.
❑ Traffic Control Plan.
❑ Road Closure Request.
❑ Tem porary Erosion&Sedim art Control(TESC)Plan.
❑ Certificate of Insurance w th the City of Arlington nam ed as Additional Insured.
❑ Assurance Device w 11 be required prior to Perm i Issuance(Bond or Assignm art of Funds).
0 Engineers Estimated Cost of Construction;$5000.00
❑ Perm t fee due at tim eof perm t issuance.
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