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�%�'�� <br />�E TT <br />PUBLIC �ORKS PERMIT <br />City of Everett Public Works Department <br />3200 Cedar Street <br />Everett, WA 98201 <br />(425) 257-8810 <br />• Date: 8/12/2015 <br />Public Works Permit #: PWW1508-003 <br />Building Permit #; BW1508-001 <br />Planning Reference #: <br />Public Works Fee $: $ 85.00 <br />Other $: <br />OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br />MAI VU OWNER <br />881381STDRNE <br />MARYSVILLE Wq 98270 <br />PHONE: 4253148582 PHONE: <br />TAX PARCEL ID # 00578700201000 SITE ADDRESS: 2222 CEDAR ST <br />DESCRIPTION OF PROPOSED WORK: <br />NEW 2 CAR DRIVEWAY CONCRETE PAD <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. Site Civil Work to be done per plans approved by the City of Everett Public Works department dated 9/2/2015. <br />5. No dirt, mud, rocks, or debris to be tracked onto roadway. Keep City streets clean at all times. <br />6. No building/paving materials to be stacked on sidewalk/roadway/alley and sidewalk/roadway/alley to be kept <br />clean and open for pedestrian/vehicular travel. <br />7. Concrete pads for parking stalls shall extend to the existing edge of paving in the alley. <br />8. Any damage to the City public right-of-way or other improvements shall be replaced at the direction of the City <br />Public Works Inspector. <br />9. It is the applicant/owner's responsibility to ensure that stormwater runoff from new impervious surfaces will be <br />managed on-site in a manner that does not adversely affect neighboring properties, including the City's right-of-way <br />and/or easements and the improvements located therein. <br />10. Contact the City of Everett Public Works Inspector Randy Allen at 425-339-7403 prior to starting construction <br />and with all other inspection requests. See attached to request an inspection. <br />Public Works Permit Fee Breakdown: <br />Paving (648sf) $45.00 <br />PW Plan Review $20.00 ACKNOWLEDGEMENT OF CONDITIONS <br />PW Site Inspection $20.00 The undersigned owner/applicant hereby agrees to hold and <br />save harmless the Cit of Everett from an and all claims for <br />. �°a,��a� ����i 9-a- aois <br />�� <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />Y Y <br />damages, costs, expenses, or causes of action that may arise <br />because of installation and maintenance of the improvement <br />or other right-of-way use hereto applied for and further agrees <br />to remove same upon notice from the City and to replace <br />public property damaged thereby. <br />/ . � .5 / S— <br />Sig ature f 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 />F.l�� <br />