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PUBLIC WORKS PERMIT Date: 9/9/2016 <br /> Public Works Permit#: PW1609-019 <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 $: $ 554.00 <br /> Other$: <br /> OWNER NAME AND ADDRESS: C <br /> 0 PAFCZNT,NAME AND ADDRESS: <br /> BRESKE FRED BRESKE FRED <br /> 6621 FOSTER SLOUGH RD 6621 FOSTER SLOUGH RD <br /> SNOHOMISH WA 98290 SNOHOMISH WA 98290 <br /> PHONE: 2067159581 PHONE: 2067159581 <br /> TAX PARCEL ID# 28042400405700 SITE ADDRESS: 2 112TH ST SW <br /> INSTALL PRIVATE ROADWAY FOR 2 NEW DUPLEXES <br /> PAVING, DRAINAGE, SEWER CONNECTIONS AND WATER SERVICES. <br /> THE CITY WATER DEPARTMENT WILL INSTALL A NEW FIRE HYDRANT AND FOUR ONE INCH WATER SERVICES <br /> AN THE DEVELOPERS EXPENCE. <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. No dirt, mud, rocks, or debris to be tracked onto roadway. <br /> 5. Site Civil Work to be done per plans approved by the City of Everett Public Works <br /> Department dated 04/05/2017. [�I <br /> 6. Contact the City of Everett Public Works Inspector Jim Knappert at 425-339-7404 <br /> prior to starting construction and with other inspection requests. See attached to request <br /> an inspection. <br /> 7. Any damage to the City Sidewalk or other improvements shall be replaced at the <br /> direction of the City Public Works Inspector. Z <br /> 8. It is the applicant/owner's responsibility to ensure that stormwater runoff from new <br /> impervious surfaces will be managed on-site in a manner that does not adversely affect <br /> neighboring properties. <br /> Public Works Permit Fee Breakdown: <br /> Paving $45.00 <br /> Erosion Control $50.00 <br /> PW Plan Review $153.00 <br /> PW Site Inspection $306.00 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 /> causes of action that may arise because of installation and maintenance of the <br /> Approved for Construction Date improvement or other right-of-way use hereto applied for and further agrees to <br /> pp remove same upon notice from the City and to replace public property <br /> damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed Signature of Applicant Date <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 />