TOWN OF BEAUX ARTS VILLAGE
BUILDING DEPARTMENT
PERMIT NO. CROW
REMOVAL OF TREES
IN RIGHT-OF-WAY
PROHIBITED
ACCEPTED _____________
APPROVED _____________
ISSUED ________________
DATE ________
DATE ________
DATE ________
10550 SE 27th Street
Beaux Arts Village, WA 98004
425.269.6985
email: bldgdept@beauxarts-wa.gov
FOR INSPECTIONS CALL:
Kolke Consulting Group, Inc.
425.255.3099
COMMERCIAL RIGHT-OF-WAY PERMIT APPLICATION
PROPERTY OWNER ____________________________________________________
PHONE ___________________________
ADDRESS ___________________________________________________________
EMAIL____________________________
OWNER’S AGENT/COMPANY______________________________________________
PHONE ___________________________
ADDRESS ___________________________________________________________
EMAIL ____________________________
ARCHITECT/COMPANY __________________________________________________
PHONE ___________________________
ADDRESS ___________________________________________________________
EMAIL ____________________________
CONTRACTOR NAME ____________________________________________________
PHONE ___________________________
ADDRESS ___________________________________________________________
EMAIL ____________________________
LICENSE NO. _________________________ EXPIRES ______________________
TAX NO.___________________________
PROPERTY LEGAL DESCRIPTION (Attach separate legal description, if necessary)___________________________________________
___________________________________________________________________________________________________________
_______________________________________________
ASSESSOR’S PARCEL NO. __________________________________
DESCRIBE DETAILS ABOUT THE LOCATION AND TYPE OFCOMMERCIAL WORK OR USE PROPOSED FOR THE RIGHT-OF-WAY, INCLUDING
THE PLANNED DURATION OF THE USE, THE AMOUNT OF PAVED SURFACE THAT WILL BE DISTURBED, THE NUMBER AND SIZES OF ANY
OVERSIZE OR OVERWEIGHT VEHICLES THAT WILL BE USED, AND PLANS FOR DIVERTING TRAFFIC FROM THE AREA, IF NEEDED:
IS WORK WITHIN 200 FEET OF LAKE WASHINGTON ORDINARY HIGH WATER LINE? YES NO
I certify under penalty of perjury that I am the owner of the above described property or the duly authorized agent of the
owner(s) acting on behalf of the owner(s) and that all information furnished in support of this permit application is true and
correct. I further certify that all applicable Federal, state, county, and Town of Beaux Arts Village requirements for the work
authorized by this permit will be met
.
SIGNATURE _______________________________________________________ OWNER AGENT DATE _______________
This section to be completed by Town staff:
PERMIT FEE $________________
RECEIPT NO. _________
TOTAL DUE AT ISSUE ________________
Form Name: CROW Permit Application Last Update: 05/2014
click to sign
signature
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TOWN OF BEAUX ARTS VILLAGE
General Permit Conditions:
1. The owner, owner’s agent, or a utility representative may apply for a Commercial ROW Use permit by submitting this form with the
necessary additional documentation and permit fee to the Beaux Arts Building Department.
2. All construction must conform to the requirements of the Town Commercial Right-of-Way Use Code found in BAV MC12.20. Other
federal, state, and local regulations may also apply. Stormwater Management Requirements in BAV MC 13.15 must be followed.
It is the responsibility of the property owner to find out all applicable laws, codes, and regulations and comply with them.
3. The permit card and other permit documents must be posted or available at the project site at all times when authorized work is in
progress.
4. Any changes to the planned construction or location of this project must be submitted to the Building Department for review prior to
the actual work taking place. Additional fees may be due before final approval of such revisions is granted.
5. Construction hours are as follows. These hours are STRICTLY enforced. A violation will result in a STOP WORK ORDER.
Monday through Friday 7 AM 6 PM
Saturday 8 AM 5 PM
Sunday and Holidays No Work Allowed
Out of courtesy to your neighbors, no construction work may take place except during these hours. This includes loading or
unloading equipment and materials, setting up for the day’s work, performing work that results in other noises that are
unreasonable for a residential area, etc.
6. Contractors are responsible for parking vehicles on the subject property or other parking spaces along Town right-of-ways
available to the general public. Streets or driveways are not to be blocked by construction vehicles. If temporary street closure is
necessary for unloading or construction work, contact the Building Department at 425.269.6985 at least 24 hours in advance so
that affected neighbors can be notified.
7. Contractors are responsible for removing dirt and construction debris from the Town right-of-way and for protecting neighboring
properties from runoff or other damage from construction.
8. The property owner is responsible for informing all contractors, subcontractors, and their employees of the requirements for
construction and to ensure their compliance. All permits issued are conditioned upon compliance with any and all provisions of the
laws, ordinances, and codes in effect at the time the permit application was filed with the Building Department. Permits issued in
error or on the basis of incomplete or inaccurate information may be suspended or revoked. Upon inspection, work found to be
constructed in violation may be ordered removed and/or brought into compliance at any time the violation becomes apparent to an
official of the Town.
9. As the property owner, it is your responsibility to retain copies of all permit documents including the application, drawings, and
supporting documents, the permit card with inspection record, and any other paperwork or information that documents the type of
work performed and its permitted status.
10. Owners and contractors should code sales tax for job-related expenditures to STATE REVENUE CODE 1703.
11. The permit conditions listed here are general conditions only. Additional permit conditions may be imposed depending on the
scope of work of your project.
I certify that I have read the general permit conditions listed above and that I understand that failure to comply with these and
any other permit conditions listed on the permit card or imposed during construction may result in a Stop Work Order.
SIGNATURE _______________________________________________________ OWNER AGENT DATE _______________
Form Name: CROW Permit Application Last Update: 05/2014
click to sign
signature
click to edit
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