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PUBLIC WORKS PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P)425-257-8810I FAX 425-257-88571(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br />PROJECT SITE INFORMATION <br />PROJECT ADDRESS: 826 PETERS PL <br />IF APPLICABLE: � IANO USE PROJECT# (SEPA PRE -PPP, SS, ETC.) <br />SITE WORK FOR PROJECT TYPE: O SMA ACHED MSFR-ATTACHED MnUPI£X OMULTI-FAMILY OCOMMERCIAL <br />CHANGE OF USE? ED NO EJ YES, FROM TO <br />NEW WATER I SEWER SERVICE NEEDED? a NO a YES, TYPE SIZE <br />SITE WORK / RIGHT-OF-WAY APPLICATION INFORMATION <br />ESCRIPTION OF WORK: GSO # 20476 <br />This project will provide an emergency fire flow interlie between the Silver Lake Water and Sewer District and the City of <br />vereR water systems in the Silver Acres neighborhood on the Northwest side of the intersection of Freeway Place and Peters <br />lace SE. The project includes the installation of approximately 45 linear feet of 8-inch ductile iron water main, gale valves, and <br />(Rings; one 2-inch blowof( assembly; a precast concrete master meter vault including piping, valving, a magnetic Now meter, an <br />Iectric motor operated valve actuator, and appurtenances; an above grade electrical equipment rack and associated electrical <br />nd telemetry equipment; and surface restoration of the site including hydroseed and hot mix asphalt pavement repair. <br />APPROVED AS NOTED 4- See TCP for notes <br />By WissinN at 3.21.48 PM, f0/18/IOM <br />ET CUTIBORE IN PAVEMENT (PARPLLEL) LF <br />Im CUTIBORE IN PAVEMENT (NON -PARALLEL) LF <br />CONTACT INFORMATION <br />OWNER NAME: IOEwnNamel <br />OWNER MAILING ADDRESS STREET Own" <br />ory [OwnCQ sTAm [OwnSt] zip [OwnZip] <br />OWNER PHONE:[OwnPhone] OWNEREMNL:[OwnEmail] <br />APPLICANT MAILING ADDRESS: >> aT 1520541et Ave SE <br />an Bothell rt . WA ZIP 98012 <br />APPLICANT PHONE: 4256592302 MPMCANTEMNL: ssmith@slwsd.0om <br />PRIMARYCONTACT: MOWNER MAPPLICANT OOTHER(Archiec(Engineer,Etc.) <br />CONTACT NAME: Edc Delfel, P.E. <br />CONTACT PNONE: 20UB 08B0 <br />CONTACT EMAIL: odegel@g<.com <br />ACKNOWLEDGEMENT: I Mre revi eae] this eAvI canon antl smfirm Ma vRwmation wrtamatl harem is hue aM curi Week tlww Weimer to Mk Perm l near <br />comply wM current MMmI, slate, aMlaallau. The 9raMing Na tons ^nH euuronre> Wesson earkantl no owialnru theMom. LAnnahon> tassel Know <br />McNeMacm otnoogrrom me SaMkg Onkreli%bre ieirgauffi a mderanyclrcumatarr[e. l am tneowner. or l am au(M1or#ed by lire owrlerOlrMsryopwlyro <br />parmnnlirewoth W"ochaW atbnlsmaee,anticomoywehthewareconhaalwa Law18.2Rcwane296"A WAc <br />c' wEwmt0iffisaibse <br />PERMIT# <br />PW2010-030 <br />EMAKRAPPLICA➢ON RECEIVED 10,19R020 (RBNsetl Y30rH110) <br />