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PUBLIC WORKS PERMIT <br />Date Applied: 10/27/2022 <br />City of Everett Permit Services <br />3200 Cedar Street, 2"d Floor <br />EV E R E T T <br />Everett, WA 98201 <br />everettwa.gov/permits <br />WASHINGTON <br />Perm itServices(@everettwa.eov <br />PERMIT FEE BREAKDOWN: <br />Misc. Minor Permit Fee(Drainage Work)...............................$25.00 <br />Paving (1,545 SF)....................................................................$45.00 <br />PW Plan Review......................................................................$20.00 <br />PW Site Inspection.................................................................$20.00 <br />Stormwater System Development Fee (1,545 SF)................$461.65 <br />Public Works Permit #: PW2210-016 <br />Associated Bldg Permit #: <br />Planning Reference #: <br />Public Works Fee: $571.65 <br />Schedule Inspections at: onlinepermits.everettwa.gov <br />ACKNOWLEDGEMENT OF CONDITIONS <br />By purchasing this permit and commencing work, the owner/applicant hereby agrees to hold and save harmless the City of Everett from any and <br />all claims for damages, costs, expenses, or causes of action that may arise because of installation and maintenance of the improvement or other <br />right-of-way use here to applied for and further agrees to remove same upon notice from the City and to replace public property damaged <br />thereby. <br />VALIDITY/EXPIRATION: <br />Work authorized by this permit must be started within 180 days of date permit is issued and thereafter is to be diligently pursued to completion. <br />This permit may be canceled by the city upon any stoppage of work on this project over 180-day duration. Each inspection extends the expiration <br />date 180 days to keep the permit open while work is active. <br />Page 2 of 2 <br />—APPLICANT/JOB SITE COPY _ADDRESS FILE _TREASURER <br />