HomeMy WebLinkAbout2026_PJA26-0239_Application Form Right-of-Way Permit Application
For submittal checklist, see below.
*denotes required fields
Project Information
*Project Name: 6025029
*Description of Project:
Place new 3x5 HH 10' from base of Pole 44, trench
10', place new conduit, install new 144 FDH cabinet
in HH, perform riser work as needed, overlash from
Pole 44 to Pole 265746 and Pole 265743, splice,
riser down, and pull through existing conduit to
Engineers Estimated Cost of Construction; $ 136011.00
Contact Information
Owner Information
*Owner Name: IZiply Fiber
*Office No.: 360-757-3406
*Email Address: wayne.wendell@ziply.cc
*Cell No.: 360-757-3406
*Mailing Address: lEverett, WA 98206
*City: lEverett
*State: WA
*Zip: 98206
Engineer Information
Engineer Name: lWayne Wendell
Office No.: 360-757-3406
Email Address: wayne.wendell@ziply.cc
Cell No.: 360-757-3406
Mailing Address: lEverett, WA 98206
City: lEverett
State: IWA
Zip: 198206
Professional License
Number:
Expiration Date:
Contractor Details
Primary Contractor: IPacific Cable Constructi�
Office No.: 425-348-7735
Email Address: ILuke@paccab.com
Cell No.: 425-348-7735
Mailing Address: IP.O. Box 573
City: Woodinville
State: WA
Zip: 198072
L&I Contractor IPACIFCC954PJ
License Number:
Expiration Date:
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: IHIKARU SAITO *Date: 2026-05-06
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.