9 9 CITY OF EVERETT PARCEL 2023-12-27

PUBLIC WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET, EVERETT, WA 98201 WASHINGTON (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I https:Heverettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS:NW of Seaway Blvd and Powder Mill Creek(on City of Everett-owned Lot 9 property) SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY ❑COMMERCIAL ✓❑INDUSTRIAL IF APPLICABLE: Ll LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) EPPLI CABLE: ElFRANCHISE/UTILITY COMPANY,ANNUAL BLANKET PERMIT# UTILITY COMPANY'S NAME&JOB M JOB# DESCRIPTION OF SITE WORK / RIGHT-OF-WAY WORK FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: DRAINAGE MITIGATION QUESTIONS: ❑FENCE IN ROW FT IN HEIGHT STORMWATER DISCHARGES TO: ❑DRIVEWAY APRON/CURB CUT FT WIDE ❑ Combined Sewer ❑ASPHALT/CONCRETE PAVING SF ❑ Separated Storm Sewer ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF ❑ Direct Discharge to Snohomish River or Puget Sound ❑ RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT TRIGGERED REQUIREMENTS: s❑ CLEARING/GRADING/FILL/EXCAVATE —5 CY ❑ MR2 Only ❑ MR1-5 ❑ MR1-9 ❑CUT/BORE IN PAVEMENT(PARALLEL) LF QUANTITY OF PROPOSED HARD SURFACES: ❑ CUT/BORE IN PAVEMENT(NON-PARALLEL) LF Proposed Roof Area:0.0 SF ❑ POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape:0.0 SF ADDITIONAL DESCRIPTION (AS NEEDED): Total New+Replaced:0.0 SF The project includes clearing an existing, overgrown dirt road to install a new extraction well and to connect the well to an existinq groundwater extraction system. New water pipes and electrical conduit will be installed in the access road. Estimated disturbed area will not exceed 2,000 sq ft (see attached). CONTACT INFORMATION OWNER/APPLICANT NAME:The Boeing Company(Deborah Taege, project manager) OWNER/APP. MAILING ADDRESS: STREET PO BOX 370/7 NC OH-13 CIN Seattle, WA STATE WA ZIP 98124 OWNER/APP. PHONE: 818-720-5575 OWNER/APP. EMAIL: deborah.a.taege@boeing.com `Required for Work in Public Right-of-Way CONTRACTOR NAME: Glacier Environmental Services CONTRACTOR ADDRESS: STREET 3415 121 St Street SW CITY Lynnwood STATE WA ZIP 98087 CONTRACTOR PHONE:425-355-2826 CONTRACTOR EMAIL:Imiles@glacierenviro.com CONTRACTOR LICENSE#(REQUIRED):GLACIES108C7 EVERETT BUSINESS LICENSE#(REQUIRED): 026280 PRIMARY CONTACT: F11 OWNER /APPLICANT ❑ CONTRACTOR ❑OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE:425-503-6784 Piper Roelen (Landau Associates) CONTACT EMAIL:proelen@landauinc.com ACKNOWLEDGEMENT.I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with current federal,state,and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building Official before being authorized under any circumstance.1 am the owner,or I am authorized by the owner of this property to perform the work for which application is made,and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# (for The Boeing Company) 11/9/2020 IPW2012-009 Owner/Authorized Agent Signature Date (Revised 1/72019)