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0 6 OCT 2Uil <br /> PUBLICIORKS PERMIT ,Date Applied: 9/20/2017 <br /> z` Public Works Permit#: PW1709-034 <br /> City of Everett Public Works Department <br /> 3200 Cedar Street Parent Permit#: <br /> Everett,WA 98201 Planning Reference#: <br /> tiliwil <br /> (425) 257-8810 Public Works Fee: $440 <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> EVERETT CITY OF APS LOCATES/JOHN GARDIN <br /> 3200 CEDAR ST 43530 SE NORTH BEND WAY <br /> EVERETT, WA, 98201 NORTH BEND, WA, 98045 <br /> PHONE: PHONE: 4258645547 <br /> TAX PARCEL ID #: 28041300104000 SITE ADDRESS: 8620 HOLLY DR <br /> DESCRIPTION: POTHOLE EXTG UTILITIES FOR AIR VALVE REPL-ALDERWOOD WTI <br /> Approx 16 potholes in the streets within the City of Everett. <br /> THIS PERMIT TO BE POSTED ON JOB SITE AT ALL TIMES <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 for Development'. <br /> 3. Call Location Underground Service 48 hours before you dig. The day you call does not count. TOLL FREE NUMBER 811. <br /> 4. Traffic Control must be done in accordance with MUTCD Standards and the Traffic Control Plan approved by City of <br /> Everett dated 10/03/2017. <br /> 5. Any damage to City improvements (sidewalk, curb, roadway, etc.) shall be replaced per City Standards and/or as <br /> directed by the City PW Inspector. <br /> 6. Street restoration must be done per COE Standard Drawing #326 and trench restoration per#614, or as directed by the <br /> City PW Inspector. Permanent restoration must be completed within 2 weeks of completion of utility work. <br /> 7. A minimum of 5ft separation between City of Everett utilities and directional boring/pavement cuts shall be maintained. <br /> 8. Contact the City of Everett Public Works Inspector Jim Knappert 425-339-7404 prior to starting construction, to evaluate <br /> traffic control set-up, with other inspection requests, and to final the permit. <br /> 9. Coordinate with adjoining businesses/homeowners to minimize obstruction of commerce/access. <br /> 10. For any proposed night work, a Temporary Noise Variance may be needed per the City's Noise Ordinance. Please visit <br /> the following website for more information: https://everettwa.gov/1547/Temporary-Noise-Variance-Requests <br /> Public Works Permit Fee Breakdown: <br /> Misc. Minor Permits. $25X16 locations........$400.00 OCr 0 6... <br /> 20 1d <br /> PW Plan Review $20.00 <br /> PW Site Inspection $20.00 Cl J'}, <br /> OF <br /> Permit Se�E1 TT <br /> City of Everett Official Use Only ACKNOWLEDGEMENT OF CONDI-I-IONS <br /> The undersigned owner/applicant hereby agrees to hold and save <br /> harmless the City of Everett from any and all claims for damages,costs, <br /> jp_ 5—'/7 expenses,or causes of action that may arise because of installation and <br /> maintenance of the improvement or other right-of-way use here to applied <br /> Appr ved for Construction (Public Works) Date for and further agrees to remove s e upon notice from the City and to <br /> replac ub• property age ereby. <br /> FINAL INSPEC,I ION Date ,' 7 / � /7 <br /> Approved as Constructed (PW Inspector) Signature of Applicant at <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLETEION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90-DAY DURATION. <br />