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PUBLIC WORK$ PERMIT <br />Date Applied: <br />4/22/2022 <br />City of Everett Permit Services <br />Public Works Permit N: <br />PW22044T28 <br />EVERETT <br />3200 cedar Street, xn0 Floor <br />Everett, WI 98201 <br />Associated Bldg Permii <br />Planning Reference <br />WASHINGTON <br />425-257-SSID <br />Public Works Fee: <br />$4,520.13 <br />OWNER NAME AND ADDRESS: <br />APPLICANT NAME AND ADDRESS: <br />CITY OF EVERETT <br />BRAD CHENOW ETH <br />3200 CEDAR ST <br />EVERETT, WA, 98201 <br />PHONE: <br />PHONE: 4x5.x574376 <br />TAX PARCEL LD A: 28053000100200 <br />SITE ADDRESS: 11807 SILVER LAKE DR <br />DP IPNON: SILVER LAKE TMLL PRWEU <br />THIS PERMIT TO BE POSTED ON JOB SITE AT ALL TIMES <br />PERMOCONDITIONS: <br />1. All calls for inspection shall be made 24 hours in advance. <br />2. All work shall be performed in accordance with the permit and current City of Everett'Design and Construction Standards and Specifications <br />for Development. <br />3. UII Location Underground Service 48 hours before you dig. The day you call does not count. TOLL FREE NUMBER Ell. <br />4. She Civil Work to be done per plans approved bythe City of Everett Public Works Department Approved plans must remain on jobSiteat <br />all times. <br />5. Inspections are required for all stages of comtmction. Visit the Gt✓s Online Permitting Portal at pw.everetlwa.gpvto formally request all <br />required inspection. A handout is provided at permit issuance with instructions on how to request an inspection Online. <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 to final approval of the permit. <br />7. Keep Ohy Streets clean at all times. No dirt, mud, rocks, or debris to betmcked onto roadway. <br />8. Protect all existing underground utilities during construction. <br />9. Any damage to City Impmvements (sidewalk, curb, roadway, etc.i shall he replaced per City Standards and/or as directed by the City PW <br />Inspector. <br />10. his the applicant/owner's responsibilityto ensure that stormwater runoff from new/replaved impervious surfaces will be managed on - <br />site In a manner that does not adver ly affect neighboring properties, Including the City's right-of-way and/or easements and the <br />improvements located therein. <br />11. Prior to any interruption to the public rightof-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 p sSeverettwa.gov and requires a traffic control plan to he <br />submitted for the area of requested closure. Please allow 1-2 weeks for TSU permit issuance from the date of application. <br />12. This permit must be finale l in order to close out this permit/grant a Certificate of Occupancy Request a final'mspectic n online by <br />selecting PW 25 Site Final/Permit Close Out within the Online Permitting Portal Inspection Requests for this permit when all items have been <br />completed. <br />Public Works PermN Fee Breakdown: <br />Erosion Control ................$2CO.CO <br />Grade/Fill/Excavate(124CY)...........................$70.00 <br />Paving(15.4331............................................$A.17 <br />PW Plan Review ....................$20.o0 <br />PW Site Inspection..........................................$20.00 <br />Stormwater System Development Fee ...... $4,132.96 <br />Oty O) Everett Offchal OU Only ACKNOWLEWEMENT OF CONDITIONS <br />By pulp using t is permit and commencing work, the owner/applicant <br />hereby agrees to hold and save harmless the CM of Everett from any <br />and all claims For damages, costs, expenses, or causes of action that <br />may arise because of Installation and maintenance m the <br />07/21/2022 improvement or other right -cal -way use here to applied for and further <br />agrees to remove same upon notice from the City and to retire <br />Appmved for Construction, Public Works Dept Date public property, damaged thereby. <br />MARZ AUTHOEVIED AN THIS PERIMIT MUST HE ��D�IN M DAYS OF DATE PERMIT IS l�M AND THEREAFTER 15 TO BE DUSENTLY PURSUED TO COMPIETION TH15 RE MIT WAY BE �C�D R THE <br />� UPON MY SPURRED OF MRK ON TH IS PIRTRACTOWER UFMTESY DUUMND EAREF! INNEXTROIJ EUENDS THE EXPIRATION DATE on DAYS TO KEEP THE PERMIT OPEN WHIREWORK ISATIEVE <br />_APPUr IJOB SITE COPY _TREASURER _ADDRESS FILE <br />