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HomeMy WebLinkAbout2026_PJA26-0240_Application Form Right-of-Way Permit Application For submittal checklist, see below. *denotes required fields Project Information *Project Name: ZIPLY PROJECT 214192 *Description of Project: PULL FIBER THROUGH EXISTING CONDUIT FROM VAULT TO EXISTING FLOWERPOTS ALONG 79TH DR NE (PRIVATE RD). BORE EAST AND PLACE ONE NEW FLOWERPOT. WORK CONTINUES ON PRIVATE PROPERTY. Engineers Estimated Cost of Construction; $ 12000.00 Contact Information Owner Information *Owner Name: IZIPLY FIBER NORTHWES *Office No.: ILLC *Email Address: Igrpatcopermits@ziplyfit *Cell No.: 402-607-8384 *Mailing Address: 1426 E Casino Rd Evereti *City: lEvertt WA 98208 *State: WA *Zip: 98208 Engineer Information Engineer Name: Office No.: Email Address: Cell No.: Mailing Address: City: State: Zip: Professional License Number: Expiration Date: Contractor Details Primary Contractor: IPACIFIC CABLE Office No.: Email Address: Juke@paccab.com Cell No.: 425-348-7735 Mailing Address: IP.O. Box 5473 Woodinvi City: WOODINVILLE State: WA Zip: 198072 L&I Contractor IPACIFCC954PJ License Number: Expiration Date: 2026-05-31 Acknowledgement I, hereby certify that I have read and examined this application, City of Arlington Municipal Code, Standard Plan & Specifications. Performance of the proposed work shall follow all applicable laws and regulations. The owner/applicant shall assume full and complete responsibility for said work and shall be responsible for the acquisition and compliance of all applicable permits and/or authorizations which may include, but not limited to, Right of Way Permit, WSDW Hydraulic Project Approval(HPA), WSDOE Notice of Intent(NOI), National Pollutant Discharge Elimination System (NPDES), Army Corp. of Engineers Permits, the requirements of the Endangered Species Act, and the Forest Practices Application (FPA). *Print Name: IDOROTHY GRAHAM *Date: 2026-05-07 Submittal Checklist Complete package constitutes all items. Only complete submittals will be acce12 Electronic files shall be PDF and submitted through this portal, email or downloadable link to file server. • Construction Plans; refer to Design Recluirements and Chanter 1 of the City of Arlington's Design and Construction Standards and Specifications Manual for required sheets. • Traffic Control Plan. • Road Closure Request. • Temporary Erosion & Sediment Control (TESC) Plan if new or replaced hard surfacing is being constructed. • Certificate of Insurance with the City of Arlington named as Additional Insured. Permit fee and any assurarnce device (Bond or Assignment of Funds) due at time of permit issuance. An invoice with link for payment will be sent to the applicant email address once permit is reviewed and approved.