HomeMy WebLinkAbout12-011 - WA State Department of Transportation (WSDOT) - I-5 Signage for Tukwila Urban Center Access (Klickitat)Washington State
M A P Department of Transportation
Paula J. Hammond
Secretary of Transportation
Northwest Region
Sno -King Local Agency and Development Services
15700 Dayton Ave. N
P.O. Box 330310 12 -011
Seattle, WA 98133 Council Approval N/A
APPLICATION FOR JA ACCOUNT
Robin Tischmak, City Engineer
City of Tukwila Public Works
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
February 6, 2012
Subject: SR 5 NB Offramp Signing
Dear Mr. Tischmak:
City File No: W1 0 I
A charge account number, JA -7677, has been opened by this office to cover WSDOT's actual costs for
reviewing submitted engineering data and plans, as well as construction inspection and preparation of an
airspace lease.
PROJECT TITLE: Tukwila Urban Access (Klickitat)
LOCATION: SR 5 NB Off Ramp MP 154 vic
DESCRIPTION OF WORK: Engineering sign design, review and construction inspection within WSDOT
right of way.
ESTIMATE COST: Approximately: $10,000.00 (actual costs may vary; written approval from
developer is required prior to exceeding estimate)
By filling out and signing the application, the City of Tukwila Public Works, agrees to pay all WSDOT
costs related to your proposed improvement, including administrative costs until this project is accepted by
WSDOT as complete. Please do not send funds at this time, an invoice will be submitted to you each
month with the charges that are incurred. Payment is due within 30 days of receipt of each invoice. Interest
of 1% per month may be charged on past due accounts.
City of Tukwila Public Works
Developer Agency Name
6300 Southcenter Blvd
Billing Address
Suite or Office Number
Tukwila, WA 98188
206 433 -0179
Phone Number
91- 6001519
Federal ID Number or SSN
Jim Haggerton
Authorized Representative (Please Print or Type)
Mayor
City, State, Zip code Title
To avoid delays, please return this c ZPX d ap plt� n as soon as possible, to the following address:
Washington State De t of Transportation
Attention: Felix Palisoc
Local Agency and Development Services, MS 240
P.O. Box 330310
Seattle, WA 98133
If you have any questions, please feel free to contact Felix Palisoc, of our Development Services section at
(206) 440- 4713 or via email at nalisof(awsdot.wa.Eov.
Sincerely,
Ramin Pazooki
Local Agency and Development Services Manager
For Department Use Only
Felix Palisoc 412463 JA 7677 0910
WSDOT Representative Org Number Job Number Work Op
WAPW Eng\PROJECTS\A- RW RS Projects \98410419 TUC Access Klickitat )VA7677_SRSNBrampSign.doc