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k <br /> Date 1/2/2007 <br /> ., 'Pup LIC WORKS <br /> Public Works Permit# Pi4701-�?(f2 <br /> PERMIT :_ Building Permit# <br /> PUBLIC WORKS DEPARTMENT Planning Reference# <br /> 3200 Cedar Street <br /> Everett,WA 98201 Public Works Fee$ 4 25.00 <br /> (425)257-8810 <br /> Guarantee$ <br /> OWNER NAME APPLICANT NAME <br /> AND ADDRESS: VANDERBEKEN RONALD AND ADDRESS: OWI4ER <br /> 5910-B LAR1FIER RD CELL -• 42 5-870--1179 <br /> EVERETT WA 98208 <br /> PHONE: 4252526828 PHONE: <br /> TAX PARCEL I.D.# PROJECT ADDRESS: <br /> 5910 LA RIPER RD #B <br /> DESCRIPTION OF RETAINING WALL - EMERGENCY REPAIR SUBJECT TO ENGINEERING <br /> PROPOSED WORK: <br /> S;*EJECT TO ENGINEERING REPORT <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 this permit and current City of Everett Design and Construction <br /> Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig.TOLL FREE NUMBER 1-800-424-5555 lail.-- <br /> 4. Engineering study and de: gin to be done by a licensed Engineer. <br /> 5. Keep public streets clean at all Lives. <br /> 6. Provide any necessary erosion control as directed by the Public Works insp 'or <br /> Your inspector is Randy Allen (425) 257--?403 • <br /> �.' �' <br /> r.,T, �.s®a- <br /> L <br /> —{ <br /> e 1,.... <br /> )ti � r•,a <br /> -3.,,r:'� <br /> Om <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> ,,/7 The undersigned owner/applicant hereby agrees to hold and <br /> ` .* i Z o 7 save harmless the City of Everett from any and all claims for <br /> App ved for Construction Date damages,costs,expenses,or causes of action that may arise <br /> because of installation and maintenance of the improvement or <br /> other right-of-way use hereto applied for and further agrees to <br /> remove same upon notice from the City and to replace public <br /> FINAL INSPECTION property dam el thereby. <br /> Approved as Constructed Date <br /> 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 PURSUED <br /> TO COMPLETION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK.ON THIS PROJECT OVER 90 DAYS DURATION. <br /> EPWP(7/06) DATABAR,INC. <br />