HomeMy WebLinkAbout283_City-of-Arlington-ROW-Application CONSTRUCTT�ON PERMIT APPLICATWN
Community&Economic Development
City of Arlington - 18204 5911,Avenue NE - Arlington,WA 98223 - Phone(360)403-3551
CIVIL (TYPE I) ® GRADING/PAVING/DRAINAGE(TYPE II) 71 RIGHT OF WAY(TYPE III) 51
TYPE I&11 ONLY NEW DEVELOPMENT ® REDEVELOPMENT
Project Name: BO Poles 95545,95546,&196515
Snohomish County Tax Parcel I.D.#:
Project Address/Location: Appx 216 E Second St Arlington WA 98223
Description of Project: PUD to replace(3)bad order poles
OWNER
Name:
Address:
City: State: Zip: Phone:
Email:
APPLICANT
Name: 5rt0hV1n1`LJ PVJ?
Address: R9 Sox 11 7
city: Fvclrtt State: 1A/4 Zip: Q 8 6 Phone: 14'2 6-- ?-3 I
Email:
ENGINEER
Name: 81151A
Address: 17 O/ S-4+j' Ave NE
city: A,-1t }in State: WA zip: fJ1 L3 Phone: dl'.I.f- 431- 7gas'
14
Email: PN13VSN P SNo AlP.L.,y, License#: Expiration:
CONTRACTOR
Name:
Address:
City: State: Zip: Phone:
Email: License#: Expiration:
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(N01),National Pollutant Discharge Elimination System(NPDES),Army Corp.of
Engineers Permitsire is of e E dangered Species Act,and the Forest Practices Application(FPA).
Signature !/�
Print Name: �� y5, I Date: 03/05/2026
Page 1 of 2 REV11/2021
Complete package constitutes all items. Only complete submittals will be accepted
Civil-Submittal Requirements Type I• Electronic files shall be PDF on USB flash-drive,email,or drop-box
❑ Complete Application
❑ 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"
❑ Marysville Utility plans,if applicable(2 sets)
❑ Drainage Analysis including calculations and downstream,analysis(2 sets)and(PDF file);refer to Stormwater Drainage
Requirements
❑ Geotechnical Report(2 sets)and(PDF file)
❑ SEPA is required if 500 or more cubic yards of cut/fill is proposed(not required if included with a Land Use Permit);if
there is not a Land Use Permit associated with the project,Public Notice Materials will be required
❑ Grading cut/fill quantity:
❑ Design Vehicle—demonstrate turning radius include 45'Fire truck,dual axle,256-inch wheelbase
❑ Drafts of easement(s)dedication(s),and/or CAPE(s)for review
❑ Flood Hazard Permit Application and required documentation if project is within 100-year flood plain;refer to Flood
Hazard guidance documents
❑ Construction Calculation Worksheet
❑ NPDES Permit(if required);See Storm Water Drainage Report,New or Redevelopment Flowcharts
❑ Assurance Device will be required prior to Permit Issuance(Bond or Assignment of Funds)
❑ Permit Fee due at time of permit submittal
Grading/Paving/Drainage Submittal Requirements Type II•Electronic files shall be PDF on USB flash-drive,email,or drop-box
❑ Complete Application
❑ Construction Plans including import/export quantities
■ 2 full size plan sets 22"x 34"
■ PDF file of the complete plan set
❑ Drainage Analysis including calculations and downstream analysis(2 sets)and(PDF file);refer to Stormwater Drainage
Requirements
❑ Geotechnical Report(2 sets)and(PDF file)
❑ SEPA is required if 500 or more cubic yards of cut/fill is proposed(not required if included with a Land Use Permit)
❑ SEPA Public Notice Material Requirements:
■ Snohomish County Assessor's Quarter Section Map: ❑ Show Subject Property ❑ Show 500 ft.Boundary
■ Current Owner List(of properties within 500ft.radius)including the following:
❑ Tax Parcel ID Number(s) ❑ Owner(s) Full Names) ❑ Owner(s) Mailing Addresses)
❑ Current Resident&Property Address(if property owner doesn't reside at the property)
■ Mailing Material:Provide❑ white,#10 envelopes with the following affixed to the envelopes:
❑ Postage ❑ Mailing Labels ❑ Return Address labels: 18204 59th Ave NE,Arlington WA 98223
❑ Grading cut/fill quantity:
❑ Construction Calculation Worksheet
❑ NPDES Permit(if required);See Storm Water Drainage Report,New or Redevelopment Flowcharts
❑ Permit fee due at time of permit submittal
Right of Way Submittal Requirements,Type III: Electronic files shall be PDF on USB flash-drive,email,or drop-box
❑ Complete Application.
® Construction Plans.
❑ Traffic Control Plan.
❑ Road Closure Request.
❑ Temporary Erosion&Sediment Control(TESC) Plan.
❑ Certificate of Insurance with the City of Arlington named as Additional Insured.
❑ Assurance Device will be required prior to Permit Issuance(Bond or Assignment of Funds).
❑ Engineers Estimated Cost of Construction;$ 33,000
❑ Permit fee due at time of permit issuance.
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