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PUBLIC lowORKS PERMIT Date: 9 2016 <br /> Public Works Permit#: PW1609-094 <br /> City of Everett Public Works Department <br /> 3200 Cedar Street Parent Permit#: <br /> Everett, WA 98201 Planning Reference#: <br /> (425)257-8810 <br /> Public Works Fee$: $ 65.00 <br /> Other $: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> HOWARD RANDOLPH E SAME <br /> 7214 LOWELL-LARIMER RD <br /> EVERETT WA 98203 <br /> PHONE: 4255955397 PHONE: <br /> TAX PARCEL ID# 28050800101300 SITE ADDRESS: 7214 LARIMER RD <br /> POUR 20'X20' CONCRETE APRON <br /> (9/23/2016 12:04 PM BES) <br /> POUR 20'X20' CONCRETE APRON IN FRONT OF SHED <br /> PERMIT CONDITIONS <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 <br /> and Specifications. <br /> 3. Call Location Underground Service 48 hrs before you dig. TOLL. FREE NUMBER 811 n; ai <br /> 4. Site Civil Work to be done per plans approved by the City of Everett Public Works , - '- r+" <br /> Department dated 09/22/2016. , <br /> 5. Contact the City of Everett Public Works Inspector Randy Allen at 425-339-7403 prior _- W <br /> T! r-i�7 fTt <br /> to starting construction and with other inspection requests. �' Cr.) <br /> 6.Keep City streets clean at all times. No dirt, mud, rocks, or debris to be tracked onto �I <br /> roadway. <br /> 8. Protect all existing underground utilities during construction. <br /> 9. Permit is only for the construction of the concrete apron. Follow the instruction on the <br /> approved plan. <br /> LTI5 •.ri� <br /> wYc>� ��7 f'•J <br /> Public Works Permit Fee Breakdown: o V G r> C <br /> Misc. Minor Permits (Drainage Work).......$25.00 <br /> PW Plan Review.......................................$20.00 �> <br /> PW Site Inspection....................................$20.00 O <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harmless the <br /> City of Everett from any and all claims for damages,costs,expenses,or <br /> 9 ' Zm�6 causes of action that may arise because of installation and maintenance of the <br /> a improvement or other right-of-way use hereto applied for and further agrees to <br /> d for Constrff, n D <br /> / remove same upon notice from the City and to replace public property <br /> da "d they .y. <br /> FINAL INSPECTION Date <br /> Approved as Constructed Signature of Applicant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY <br /> PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />