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PUBLIC WORKS PERMIT <br />Date Applied: <br />3/30/2023 <br />City of Everett Permit Services <br />Public Works Permft#: <br />PW2303.021 <br />3200 Cedar street, 2"a Floor <br />Associated Bldg Permit#: <br />EVERETTEverett, <br />WA 98201 <br />Planning Reference#: <br />everettwa.eov/permits <br />Public Works Fee: <br />$115.00 <br />WASHINGTON <br />Perm it5e rvices Reyerettw a. gay <br />Schedule Inspections at: onl'meoermits.everettwa.eov <br />OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br />EVERETT PORT OF <br />EVERETT PORT OF <br />PO BOX 538 <br />PO BOX 539 <br />EVERETT, WA 98206 <br />EVERETT, WA 98206 <br />PHONE: 4252593264 <br />PHONE: 4252593160 <br />SITE ADDRESS: 620 MILLWRIGHT LOOP N TAX PARCEL ID#: n05l8W2O9NO <br />THIS PERMIT TO BE POSTED ON JOB SITE AT ALL TIMES <br />DESCRIPTION: BOXCAR PARK LIFT STATION REPLACEMENT <br />NOTES: The existing sanitary sewer lift station adjacent to Boxcar Park has failed. This project involves the removal and replacement of <br />this lift station. This project is classified as an underground utility project that replaces the ground surface with Inkindmaterial. As such <br />only MR 2 applies. <br />PERMOCONDITIONS: <br />1. All inspections shall be scheduled online at htcos://onlineoermits.everettwa.eov. Available Inspection dates are shown in the dropdown <br />2. All work shall be performed in accordance with the permit and current City of Everett'Design and Construction Standards and <br />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. Site Civil Work to be done per plans approved by the City of Everett Public Works Department. Approved plans must remain on job -site at <br />all times. <br />5. Inspections are required for all stages of construction. Visit the City's Online Permuting Portal at onlinepermi s.everettwa.gov to formally <br />request all required inspections. <br />6. Install and maintain erosion control measures per City of Everett Standards and per the direction of the PW Inspector and the approved <br />SW PPP/TESC Plan. Remove upon completion of the project prior final approval of the permit. <br />T. Keep City streets clean at all times. No dirt, mud, rocks, or debris to be tracked onto roadway. <br />8. Protect all existing underground utilities during construction. <br />9. Any damage to City improvements (sidewalk, curb, roadway, etc.) shall be replaced per City Standards and/or as directed by the City PW <br />Inspector. <br />10. Separate UtilNv permit For sewer aRe on/repair and Electrical permit for electrical work required. <br />11. Prior to any interruption to the public rightrot- way (roadways, parking lanes, or sidewalks) a Traffic Street Use permit shall be obtained <br />from the City's Traffic Engineering Division. This permit can be applied for online at onlinepermitt.evemtt a.gov and requires a traffic <br />control plan to be submitted for the area of requested closure. Please allow 1-2 weeks for TSU permk Issuance from the date of application. <br />12. This permit must be finaled in order to close out this permit/gram a Certificate of Occupancy. Request a final inspector online by selecting <br />PW 25-Site Final/Permit Close Out within the Online Pennitting Portal Inspection Requests for this Permit when all items have been <br />completed. <br />PERMIT FEE BREAKDOWN: <br />Erosion Control .......................................................................$50A0 <br />Grade/Fill/Excavate(20 CY)....................................................$25.00 <br />PW Plan Review......................................................................$20.00 <br />PW Site Inspection.................................................................$20.00 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />By purchasing this permit and commencing work, the owner/applicant hereby agrees to hold and save harmless the City of Everett from any and <br />all claims for damages, costs, expenses, or causes of action that may arise because of Installation and maintenance of the Improvement or what <br />right-of-way use here to applied for and further agrees to remove same upon notice from the City and to replace public property damaged <br />thereby. <br />Page 1 of 2 <br />_APPUCANT/IOa SRE COPY _ADDRESS FILE _TREASURER <br />