HomeMy WebLinkAbout328_6015263----Application Access Hub H3015 and install jumper,then from the existing handhole install a new drop in the
terminal and bore approximately 60 feet across Olympic PI NE.Continue boring 173 feet south along
0 Olympic PI NE to existing Pedestal 8099,then pull fiber through existing conduit to the customer
location at 7705 204th St NE.
CONSTRUCTION PERMIT APPLICATION
Community&Economic Development
City ofArlington • 18204 591h 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 DEVELOPMENT ❑ REDEVELOPMENT ❑
Prq•ect Name: 6015263
Snohomish Coun Tax Parcel I.D. A 00847300000400
Project Address/Location: 7705 204th St NE,Arlington WA
Description of Project: Access Hub H3015 and install jumper,then from the existing handhole install a new drop in the terminal and bore
approximately 60 feet across Olympic PI NE.Continue boring 173 feet south along Olympic Pl NE to existing Pedestal 8099,then pull fiber through
existinR conduit to the customer location at 7705 204th St NE.
OWNER
Name: Walenda Lynn
Address: 303 Gardner Rd.Burlington WA 90233
City: Burlington State: WA Zip: 90233 Phone:
Email:
APPLICANT
Name: Ziply Fiber Northwest, LLC
Address: 426E Casino Rd.
City: Everett State: WA Zip: 98208 Phone: 402-670-8384
Email: grpatcopermits(@ziply.com
ENGINEER
Name:
Address:
City: State: Zip: Phone:
Email: License#: Expiration:
CONTRACTOR
Name: Pacific Cable Construction, Inc.
Address:P.O. Box 573
Citv: Woodinville State: WA Zip:98072 Phone: 425-348-7735
Email: Luke@oaccab.com License#: P A C I F C C 9 5 4 P Expiration: 05/31/2026
1 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 pemlits and/or authorizations which may include, but not limited to, Right of Wuy
Penuit,WSOW Hydraulic Project Approval (HPA,WSDOE Notice of Intent(NOi National Pollutant Discharge Elimination System (NPDE$Anny Corp. of
Engineers Permits,the requirements o81le Endangered Species Act; and the Forest Practices Application (FPA
Signature___ ___ rL
Print Name: Jason Vieira Date:--4/1/2026
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Page 1 of2 REV11/2018
.Complete package constitutes all items. Only complete submittals will be accepted._
Civil -Submittal Requirements,Type I:
D Complete Application;
D Construction Plans including cut/fill quantities;
. 2 full size plan sets 22"x 34"
• PDF file of the complete plan set
. 2 full size set of landscape plans 22"x 34"
D Marysville Utility plans, ifapplicable (2 sets);
D Drainage Analysis including calculations and downstream analysis (2 sets) and (PDF file); refer to Stormwater Drainage
Requirements;
D Geotechnical Report (2 sets) and (PDF file);
D SEPA is required if 500 or more cubic yards of cut/ fill is proposed (not required if included with a Land Use Permit);
D Grading cut/ fill quantity: --------
D Design Vehicle - demonstrate turning radius include 45' Fire truck, dual axle, 256 inch wheel base;
D Complete Streets Checklist
D Drafts of easement(s) dedication(s), and/or CAPE(s) for review;
D Flood Hazard Permit Application and required documentation if project is within 100 year flood plain; refer to Flood
Hazard guidance documents;
D Construction Calculation Worksheet;
D NPDES Permit (if required); See Storm Water Drainage Report, New or Redevelopment Flowcharts,
D Assurance Device will be required prior to Permitlssuance (Bond or Assignment of Funds);
D Permit Fee due at time of permit submittal.
Grading/Paving/Drainage Submittal Requirements,Type I1:
D Complete Application;
D Construction Plans including import/export quantities;
. 2 full size plan sets 22"x 34"
. PDF file of the complete plan set
D Drainage Analysis including calculations and downstream analysis (2 sets) and (PDF file); refer to Stormwater Drainage
Requirements;
D Geotechnical Report (2 sets) and (PDF file);
D SEPA is required if 500 or more cubic yards of cut/fill is proposed (not required if included with a Land Use Permit);
D Grading cut/ fill quantity: ---------
D Construction Calculation Worksheet;
D NPDES Permit (ifrequired); See Storm Water Drainage Report, New or Redevelopment Flowcharts,
D Permit fee due at time of permit submittal.
Right of Way Submittal Requirements,Type III:
Complete Application;
5Q Construction Plans;
Traffic Control Plan;
❑ Road dosure Request;
❑ Temporary Erosion &Sediment Control (TESC) Plan;
❑ Certificate oflnsurance with the City ofArlington named as Additional Insured;
❑ Assurance Device will be required prior to Permit Issuance (Bond or Assignment of Funds);
Engineers Estimated Cost of Construction; $____________
QI Permit fee due at time of permit issuance.
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