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PUBLIC WORKS PERMIT Date: 7/24/2014 <br /> Public Works Permit#: PW1407-026 <br /> City of Everett Public Works Department <br /> �� 3200 Cedar Street Building Permit#; <br /> Everett, WA 98201 Planning Reference#: <br /> (425)257-8810 <br /> Public Works Fee$: $ 25.00 <br /> Other$: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> SHELL OIL PRODUCTS, U.S. BLAINE TECH SERVICES, INC. <br /> 20945 S.WILMINGTON AVE. 20735 BELSHAW AVE <br /> CARSON CA 90810 CARSON CA 90746 <br /> PHONE: 4254131164 PHONE: 3108854455 <br /> TAX PARCEL ID# SITE ADDRESS: 1816 112TH ST SE <br /> DESCRIPTION OF PROPOSED WORK: <br /> GROUND WATER MONITORING <br /> (7/24/2014 10:33 AM BES) <br /> ROUTINE GROUND WATER MONITORING OF EXISTING WELL(MW-16) <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 <br /> 4. Traffic control per previously approved plan 12/24/2013 by the traffic engineer. <br /> 5. Contact City of Evrett Inspector Cliff Lindman 425-339-7404 P=; 1 x;•;;' <br /> prior to starting construction. 1-- `' <br /> =I „ E.* <br /> . c i� <br /> € <br /> - <br /> i <br /> ra 1 <br /> io <br /> m ..,Lip <br /> Lil <br /> 404 )ie,-;:,..Ca <br /> ICY-... <br /> • <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> 411, The undersigned owner/applicant hereby agrees to hold and <br /> save harmless the City of Everett from any and all claims for <br /> damages,costs,expenses,or causes of action that may arise <br /> ‘,/ because of installation and maintenance of the improvement <br /> . __� l>ti,f4 . " 2 /14(,( or other right-of-way use hereto applied for and further agrees <br /> App'ed for Constr ctio D e �/ to remove same upon notice from the City and to replace <br /> public property damaged thereby. <br /> FINAL INSPECTION Date �-�� / /z Oct <br /> Approved as Constructed lgnature 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 />