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elp / PUBLIC WORKS PERMIT Date: 10/6/2014 <br /> City of Everett Public Works Department Public Works Permit#: PW1410-009 <br /> • - 3200 Cedar Street Building Permit#; C1410-001 <br /> E 7,� EverettWA 98201 <br /> � (425)257-8810 Planning Reference#: <br /> Public Works Fee$: $ 40.00 <br /> Other $: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> HAYNACK STEVEN <br /> 1001 MAPLE <br /> EVERETT WA <br /> PHONE: PHONE: <br /> TAX PARCEL ID# 00434203803900 SITE ADDRESS: 1001 MAPLE ST <br /> DESCRIPTION OF PROPOSED WORK: <br /> PUBLIC WORKS FOR ADDITION & DECK <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 <br /> 4. Roof drains from the new addition cannot connect to the sewer system. <br /> 5. The contractor must meet with the Public Works Inspector to discuss a storm wl p 1 . .:;1r' ng to <br /> project. Call Randy Allen at 425-339-7403. —42E1 C-) • W <br /> r •- <br /> � <br /> `-y r <br /> • <br /> a ra r•,: f-••+s+LTi C-.J <br /> r•.1(�L c�ci cf•��v L��LT1 <br /> 1,7% a CG LTi H-• <br /> SIZA <br /> I—' <br /> • <br /> • <br /> C <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and <br /> save harmless the City of Everett from any and all claims for <br /> damages,costs,expenses, or causes of action that may arise <br /> because of installation and maintenance of the improvement <br /> • Mil 0.1.7',./ - ,/ or other right-of-way use hereto applied for and further agrees <br /> Appr► ed sr� onru '� y Date to remove sa e upon notice from the City and to replace <br /> J public pro y damaged thereby. <br /> NAL INSPE i Date ( `'"! <br /> / <br /> Approved as Constructed Signature of Ap icant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATF PFRMIT Tc icci IFA Arkin TI-IFPFAI TID IC Tr-1 DC nig Tr-cnrri v <br /> Pw <br />