Laserfiche WebLink
MISS PUBLIC WORKS PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />EVERETTBVeMNTILIN,TRUCTIONeemail >ppirali a>vtoweal Immune on Pamill3>n-IwsNeverelN>.go.a, wor ca at mass come Smse 210 FW, bcPPa, <br />CONTACT INFORMATION(P)02L26P8810I(E)Pe,mdSewices®evere .9ovl(W)everelMa.9ovlPo=No <br />PROJECT SITE <br />PROJECT ADDRESS: Wino Foods SNre No. 104 - 9900191n Avenue SE <br />SITE WORK FOR PROJECT TYPE: OSFR-DETACHED OTOWNHOUSE OWPLEx DADU OMULTWAMILY IiCOMMERCIAL OINDUSTRIAL <br />IF APPLICABLE: D LAND USE PROJECT# (SEPA, PREAPP, SS, ETC.) NA <br />IFAIPLICABLE: QFRANCHISEIUTILITY COMPANY, ANNUAL BWNKET PERMIT#NIA <br />UTILITY COMPAIII NAME S JOB C: JOBM <br />or DESCRIPTION OF III <br />FILL IN ALL QUANTITIES OF WORK BE LOW, AS APPLICABLE: <br />El FENCE IN ROW FT IN HEIGHT <br />❑ DRIVEWAY APRON I CURB CUT FT WIDE <br />D ASPHALT I CONCRETE PAVING SF <br />D RETAINING WALL I ROCKERY IN RIGHT-OF-WAY _LF <br />❑ RETAINING WALL I ROCKERY OVER CFT IN HEIGHT FT TOTAL HEIGHT <br />13 CLEARING I GRADING I FILL I EKCAVATE CY <br />❑ CUTWRE IN PAVEMENT( PARALLEL) LF <br />O CUTIBORE IN PAVEMENT (NON -PARALLEL) LF <br />D POLE WORK I AERIALI OVERI-I LF <br />ADDITIONAL DESCRIPTION AS NEEDED : <br />F-WAY WORK <br />DRAINAGE MRIGATION QUESTIONS: <br />STORMWATER DISCHARGES TO: <br />17 CombYNSeser <br />■SelsvaNd made 5Bxer <br />O Dead OkMage to SmMmw River a PuaM Sound <br />TRIGGERED REQUIREMENTS: <br />Omni Chl 0111 <br />QUANTITY OF PROPOSED HARD SURFACES' <br />Reported Post Aide. SF <br />Removal Handsome: SF <br />TOISI New a Replaced aF <br />Modification of WInCo lower pond overflow, modification Wini upper pond berm, installation of backwater valve in <br />exls Ing 3 OFF a er conveyance sys em. <br />CONTACT INFORMATION <br />OWNER I APPLICANT NAME: reNall Schneber- WInCo FVAa <br />OWNER/APP. MAILINGADDRESS: Carl N. Amletrolg Place <br />cli Boise R Idaho ZIP 837O4 <br />OWNER I APP. PHONE 208859-1993 <br />OWNER IMR. EMAIL, tonalA.schtiehenowincoloods.eom <br />'Required for Work In Public RI9h1M-Way <br />CONTRACTOR NAME: Aqualis <br />CONTRACTORADDRESS: wi 20905 Toth Avenue <br />carry EUmords STATE WA or 98026 <br />CONTRACTOR PHONE: 800.945.4U91 <br />CONTRACTOR EMAIL 2roemer@aquNisco.com <br />CONTRACTOR LICENSE kIREDUIRED:INNOV"803M1 <br />EVERETTBUSINESSUCENSE*(REQUIRED): 62393 <br />PRIMARY CONTACT: ❑ OWNER I APPLICANT ❑CONTRACTOR IS OTHER (Architect, Engineer, Etc.)e"s'"••' <br />CONTACT Ni <br />Brandon Johnson <br />CONTACT PHONE:960.269.63f6 <br />CONTACT EMAIL:hmn4enklv�meRWvaa�n <br />ACKNOWLEDGEMENT: the" revieaetllM1isappficalicnaMconfirm the irdorma(ion conlamed M1Brein is hueaMmrmc(. WMMnepursuari thispa rrarnm Y <br />romplY Mli csame leler M SuA BMbceskide Tie exam waOre pemry pry eu*wds9 apynv¢tl wnh eMnp tleNBEbn4fhMIT'n. DCVIBtW,9 mWf flmf bC <br />aNsent are <br />in ake Imimu e a BurMirg is male, and being a We the SaamCunderannoirtuns Low 1 I am ICWmm2, wl am autM1orhetlby MBOnraIW(M1isprcMy b <br />pertorm Ilre waM brwYlkM1 applkalion Is made, and I cmplY wIM the Slate COntxclOrs Law 182] RCW erM 296.200A WAC. <br />DlgimllV sgned W Brandon IFJOhmon CiryWEvpg10/lrciel Use OMy <br />Data WM.09.1211 :00270700PW <br />OWRBNANIM1OriBetl Agent 5igmi Dale (RBviand 42IM22) <br />