Laserfiche WebLink
JBLIC WORKS PERMI-WPPLICATION <br /> CITY OF EVERETT PERMIT SLRVICES <br /> EVERETT 3200 CEDAR STREET, EVERETT, WA 98201 <br /> WASHINGTON (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov https://everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS:9307 18th Ave W, Everett, WA 98204 <br /> SITE WORK FOR PROJECT TYPE: ❑✓SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX EADU EMULTI-FAMILY COMMERCIAL ['INDUSTRIAL <br /> IF APPLICABLE: ❑✓ LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.)SEPA19-009, REV1119-037 <br /> IF APPLICABLE: ❑ FRANCHISE/UTILITY COMPANY,ANNUAL BLANKET PERMIT# <br /> UTILITY COMPANY'S NAME&JOB#: JOB# <br /> DESCRIPTION OF SITE WORK / RIGHT-OF-WAY WORK <br /> FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: DRAINAGE MITIGATION QUESTIONS: <br /> ❑FENCE IN ROW FT IN HEIGHT STORMWATER DISCHARGES TO: <br /> ❑DRIVEWAY APRON/CURB CUT FT WIDE ❑ Combined Sewer <br /> ❑ASPHALT/CONCRETE PAVING SF ❑ Separated Storm Sewer <br /> ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF ❑ Direct Discharge to Snohomish River or Puget Sound <br /> ❑ RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT TRIGGERED REQUIREMENTS: <br /> ❑ CLEARING/GRADING/FILL/EXCAVATE CY ❑ MR2 Only ❑ MR1-5 ❑ MR1-9 <br /> ❑ CUT/BORE IN PAVEMENT(PARALLEL) LF QUANTITY OF PROPOSED HARD SURFACES: <br /> ❑ CUT/BORE IN PAVEMENT(NON-PARALLEL) LF Proposed Roof Area: SF <br /> ❑ POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: SF <br /> ADDITIONAL DESCRIPTION (AS NEEDED): Total New+Replaced: SF <br /> The applicant is responding to a violation issued by the City of Everett regarding the unpermitted <br /> removal of a beaver dam and streambank vegetation by restoring vegetation along the subiect <br /> segment of stream (Swamp Creek). <br /> CONTACT INFORMATION <br /> OWNER/APPLICANT NAME: Robin & Lance Talley <br /> OWNER/APP. MAILING ADDRESS: STREET 9307 18th Ave W <br /> CITY Everett STATE WA ZIP 98204 <br /> OWNER/APP. PHONE:425-359-3070 OWNER/APP. EMAIL:rWOIVeS1960@gmall.COM <br /> *Required for Work in Public Right-of-Way <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: ❑ OWNER /APPLICANT ❑ CONTRACTOR ❑✓ OTHER (Architect, Engineer, Etc.) Ecologist-Wetland Resources Inc. <br /> CONTACT NAME: CONTACT PHONE:425-337-31 74 <br /> John Laufenberg, Wetland Resources Inc. CONTACT EMAIL:john@wetlarldresources.com <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must <br /> 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 <br /> 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 <br /> perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> /2 S/ PW 2--00 QQ� <br /> Owner/Authorized Agent Signature Date (Revised 1/72019) <br />