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- _ , , PUBLIC O RKS PERMIT Date: 3/6/2017 <br /> -� 41111 <br /> } ' Public Works Permit#: PW1703-011 <br /> City of Everett Public Works Department <br /> 3200 Cedar Street Parent Permit#: <br /> ` Everett, WA 98201 Planning Reference#: <br /> (425)257-8810 <br /> Public Works Fee$: $ 65.00 <br /> Other$: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> KOCTONOWSKI EDWARD KOCTONOWSKI EDWARD <br /> 2514 51ST ST SW 2514 51ST ST SW <br /> EVERETT WA 98203 EVERETT WA 98203 <br /> PHONE: 4254183245 PHONE: 4254183245 <br /> TAX PARCEL ID# SITE ADDRESS: 2514 51ST ST SW <br /> REPAVE DRIVEWAY WITH CONCRETE <br /> PERMIT CONDITIONS <br /> 1. All calls for inspection shall be made 24 hours in advance. <br /> 2. All work shall be performed in accordance with the permit and current City of Everett Design and Construction Standards <br /> and Specifications. <br /> 3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 n —I r; <br /> Ca <br /> 4. The contractor/owner must meet with the Public Works Inspector to discuss potential _, ,- ,� --1 " w <br /> drainage routing and other issues prior to beginning the project. Call Randy Allen at �-, ca <br /> 425-339-7403. ' c '" .3 EI <br /> LA <br /> 5. Keep city streets clean at all times. m a c4 <br /> �z <br /> 6. Connect to the existing pavement as directed by the Public Works Inspector. r <br /> . � r. <br /> L,0...:•,a:7 <br /> ' ''"81-- <br /> . <br /> Public Works Permit Fee Breakdown: <br /> ` <br /> Misc. Minor Permits $25.00 4-= <br /> PW Plan Review $20.00 O <br /> PW Site Inspection $20.00 a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harmless the <br /> City of Everett from any and all claims for damages,costs,expenses,or <br /> —� 7 causes of action that may arise because of inst-Il-tion and maintenance of the <br /> A roved for Construction Date improvement or other right-of-way . er V. .•lied for and further agrees to <br /> p remove same upon notice fro rv�- Ci an, o replace public property <br /> damaged thereby. <br /> FINAL INSPECTION Date e <br /> /� (7 <br /> Approved as Constructed Signature of Applicant Da <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY <br /> PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />