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PUBLIC IORKS PERMIT Date: 11/.243>2-016 <br /> Public Works Permit#: PW1611-040 <br /> City of Everett Public Works Department <br /> 3200 Cedar Street Parent Permit#: <br /> Everett, WA 98201 <br /> Planning Reference#: <br /> (425) 257-8810 <br /> Public Works Fee$: $ 65.00 <br /> Other $: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> OSTLER DANIEL OSTLER DANIEL <br /> 220 76TH ST SW 220 76TH ST SW <br /> EVERETT WA 98203 EVERETT WA 98203 <br /> PHONE: 4254229059 PHONE: 4254229059 <br /> TAX PARCEL ID# SITE ADDRESS: 220 76TH ST SW <br /> WIDEN EXISTING DRIVEWAY PER HEARING EXAMINER ORDER <br /> VIOLATION HEARING EXAMINER CASE NO: CE16-0705 <br /> APPLICANT IS PROPOSING TO RE-GRAVEL THE AREA AS INDICATED IN THE HEARING EXAMINER ORDER OR <br /> INSTALL GRASS-CRETE. <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. AREA OF WIDENNING TO BE DONE AS SHOWN ON ATTACHED SKETCH DATEC <br /> 11/10/2016 L.J r.:1 F.' a?: at Wi4 <br /> L7.3 r`i a <br /> 5. KEEP EXISTING STREET CLEAR OF GRAVEL AT ALL TIMES. ''•c.. • <br /> c8ar'i r•• <br /> C <br /> Public Works Permit Fee Breakdown: <br /> PW Plan Review $20.00 -• r•._�r•'s <br /> I TT A. <br /> r_T'( <br /> PW Site Inspection $20.00W} -,ra <br /> Driveway $25.00 <br /> .tea•,i,.�,; �y <br /> r•.) T/1 <br /> O <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 /> I/ / _.. /Z—'I—4, causes of action that may arise because of installation and maintenance of the <br /> A •ved for Construction Date improvement or other right-of-way use hereto applied for and further agrees to <br /> p remove same upon notice from the City and to replace public property <br /> dam d thereby. <br /> FINAL INSPECTION Date ��� lr:. <br /> f./ /C <br /> � eApproved as Constructedigriggf Applicant [1"ate <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 />