830 W MUKILTEO BLVD 2024-12-02 - Laserfiche WebLink

PUBLIC WORKS PERMIT APPLICATION `i CITY OF EVERETT PERMIT SERVICES EVERETTSUBMITTAL INSTRUCTIONS:Email application&submittal documents to PermitServices@everettwa.gov or drop off at 3200 Cedar Street 2nd Floor Drop Box WASHINGTON CONTACT INFORMATION:(P)425-257-8810 i(E)PermitServices@everettwa.gov i(W)everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS:Gravel area on the North side of W Mukilteo Blvd, between Ridgemont Dr& Glenhaven DR SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU []MULTI-FAMILY BCOMMERCIAL ❑INDUSTRIAL IF APPLICABLE: ❑ LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) IF APPLICABLE: ❑FRANCHISE/UTILITY COMPANY,ANNUAL BLANKET PERMIT# UTILITY COMPANY'S NAME&JOB M JOB M 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 I CURB CUT FT WIDE ❑ Combined Sewer ❑ASPHALT I 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: ❑CLEARING/GRADING/FILL/EXCAVATE 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: SF ❑ POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: SF ADDITIONAL DESCRIPTION (AS NEEDED): Total New+Replaced: SF We would like to use this as a temporary stockpile location containing structural backfill and exported dirt material uSlliy ucublul arid Other protective IfleaSUreb 60 thi�i Ulaterial dues riot leave the site. Our project is oil Shure CONTACT INFORMATION OWNER I APPLICANT NAME: Redtail LLC-Anne Rasmussen OWNER/APP. MAILING ADDRESS: STREET PO Box 2394 CITY Snohomish STATE ••A ZIP 98290 OWNER/APP. PHONE: 360-208-0234 OWNER/APP. EMAIL:ARasmussen@Redtailco.com 'Required for Work in Public Right-of-Way CONTRACTOR NAME: Redtall LLC CONTRACTOR ADDRESS: STREET 8812 36th St SE CITY Snohomish STATE WA z,P 98296 CONTRACTOR PHONE:360-208-0234 CONTRACTOR EMAIL:ARasmuSsen@Redtallco.com CONTRACTOR LICENSE#(REQUIRED):REDTAL*834MK IEVERETT BUSINESS LICENSE#(REQUIRED): 60775 PRIMARY CONTACT: Iiii OWNER /APPLICANT R CONTRACTOR ❑ OTHER(Architect, Engineer, Etc.) CONTACT NAME:Anne Rasmussen CONTACT PHONE:206-229-6280 CONTACT EMAIL:ARasmussen@Redtailco.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. I 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 It PW Owner/Authorized Agent Signature Date (Revised 412112022)