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• Date: 7/29/2016 <br /> PUBLICWORKS PERMIT <br /> Public Works Permit#: PW1607-056 <br /> City of Everett Public Works Department <br /> 3200 Cedar Street Parent Permit#: <br /> Everett, WA 98201 <br /> (425) 257-8810 Planning Reference#: <br /> Public Works Fee$: $ 65.00 <br /> Other $: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> JOHNSON RAY JOHNSON RAY <br /> 746 CROWN DR 746 CROWN DR <br /> EVERETT WA 98203 EVERETT WA 98203 <br /> PHONE: 4254186794 PHONE: 4254186794 <br /> TAX PARCEL ID# SITE ADDRESS: 746 CROWN DR <br /> INSTALL CULVERT PIPE IN DITCH <br /> WORK ALONG PROPERTY FRONTAGE AT EDGE OF ROADWAY <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 73 —t:: <br /> 4. Traffic Control must be done in accordance with MUTCD Standards as applicable ___,�-,-,-, <br /> —i <br /> revjiew with inspector. rp <br /> CC)•s;_. <br /> 5. Any damage to City improvements (sidewalk, curb, roadway, etc.)shall be replaced <br /> per City of Everett Standards and as directed by the City Public Works Inspector ' <br /> 6. Contact the City of Everett Public Works Inspector Randy Allen at 425-339-7403 prior ;0 <br /> to starting construction, to evaluate traffic control set-up, and with other inspection � a <br /> requests. See attached to request an inspection. <br /> 7. Use concrete pipe or approved equal. Consult with Public Works Inspector. <br /> Public Works Permit Fee Breakdown: O <br /> PW Plan Review$20.00 <br /> PW Site Inspection $20.00 <br /> Misc. Minor Permits$25.00 <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 /> _ _ 6 causes of action that may arise because of installation and maintenance of the <br /> improvement or other right-of-way use hereth applied for and further agrees to <br /> Ap oved for Construction Date remove same upon notice from t tyand to replace public property <br /> damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed Si na ure�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 /> H VC�,' <br />