3903 FRIDAY AVE 2023-07-31 - Laserfiche WebLink

PUBLIC WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETTeUBMRTAL INSTRUCTIONS: Email appeorRn B submean candidate go, or drtp off .13An Ceder amen 2nd Bad Drop PoR WASHPINGTON CONTACT INFORMATION. (P) 425 25T 88101(E) PermuSenacesQe aralMagw l lw)everetlxa.pw/Pormils PROJECT SITE INFORMATION PROJECT ADDRESS: 3903 Friday Ave, Everett, WA 98201 SITE WORK FOR PROJECT TYPE: f3SFR-DUAOHED OTOWNHOUSE ODUPIF% DAOU OMUIL FAMILY OCOMMERCIAL OINDUSTRIAL IF APPLICABLE: Mt ND USE PROJECT N (SEPA, PRE-APP, SS. ETC.) IF APPLICABLE: I]FRANCHISENTILITY COMPANY, ANNUAL BLANKET PERMIT A UTILITY COMPANY'S NAME B JOB It: JOB At: DESCRIPTION OF SI FILL IN ALL QUANTITIES OF WORK BELOW, AS APPLICABLE: ❑ FENCE IN ROW FT IN HEIGHT ❑ DRIVEWAY APRON I CURB CUT FTWIDE ■ ASPHALT I CONCRETE PAVING 540 SF ❑ RETAINING WALL I ROCKERY IN RIGHT-OF-WAY LF ❑ RETAINING WALL I ROCKERY OVER JET IN HEIGHT FT TOTAL HEIGHT ❑ CLEARING) GRADING) FILL I EXCAVATE OY O CUTWRE IN PAVEMENT(PARALLEL) LF O CUTWRE IN PAVEMENT (NON -PARALLEL) LF ❑ POLE WORK I AERIAL I OVERLASH LF ADDITIONAL DESCRIPTION AS NEEDED): F-WAY WORK DRAINAGE MITIGATION QUESTIONS: STORMWATER DISCHARGES TO: GOombined Satyr O Separated Storm Sander O Damn Diembarge to Sualnmish River or Popet Sound TRIGGEREDREQUIREMENTS: ❑MR2Only E3MR1-5 DUBUC QUANTITY OF PROPOSED HARD SURFACES: Proposed Rood Area: SF Proposed Herdarape: SF Tonal Nary a Replaced 540 BE We are seeking to pave a ponion of an exisiting gravel driveway. Current impervious surface is gravel and din. CONTACT INFORMATION OWNER I APPLICANT NAME:TyBON Bailey OWNER I ARE. MAILING ADDRESS: STRET3903 Friday Ave n TY Everett ATATEWA 0.98201 OWNER IMP. PHONE: 2065956596 OWNERI"P. EMAIL:tdbailey82�%Ogmail.com 'Required for Work In Public Riphto! Way CONTRACTOR NAME: CONTRACTOR ADDRESS: amida CONTRACTOR PHONE: CONTRACTOREMAIL: CONTRACTOR LICENSE ANREW IREDy EvedtETT BUSINESS LICENSE u(REOUIRIEU: PRIMARY CONTACT: O OWNER I APPLICANT ❑CONTRACTOR ❑ OTHER(Anchipct, Engineer, Etc.) CONTACT NAME:O,^,nQY YY11G1 CONTACT PHONE: CONTACT EMAIL: ACKNOWLEDGEMENT I Mre rewawtl this apoki'afien amid ranged Me information conhimO berem is hua and wmLi. Wwk Mow paccam lro M s Pormrt mint aunWy NOT Current Random' water and di law. The Counting an a pardi any meanous recovered aarx and no dawatuns Specimen, lawadmns mwt firm on, eNlMmd m Cramp hen Ma Bulldmp OMcbl bs/ore being eNlMmtl on darany cirtomslensa. I am the owner, al am audhodmtl by Me owner dthis pmpsty to random ttm work for Much ap tion is Carl and I comply bank the State Conhectom Law 1827 ROW eM MOMA WAC. C o/EreneH OMnal Use QMy FIEKIMI /�- 2/25/23 IPW 19 OwneMAUMorized Agent Signature Data (ReARMUW12022)