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• <br />�f..f`i ����� �"�R�'� <br />City of Everett Public Works Department <br />3200 Cedar Street <br />Everett, WA 98201 <br />(425) 257-8810 <br />OWNER NAME AND ADDRESS: <br />DUBA TERRELL S & SAMANTHA <br />2128 100TH ST SE <br />EVERETT WA 98208-3835 <br />PHONE: 4252327729 <br />TAX PARCEL ID # 28052000204200 <br />RE-PAVE EXISTING DRIVEWAY <br />• <br />Date: 6/6/2016 <br />Public Works Permit #: PW1606-005 <br />Parent Permit #: <br />Planning Reference #: <br />Public Works Fee $: $ 65.00 <br />Other $: <br />APPLICANT NAME AND ADDRESS: <br />DUBA TERRELL S & SAMANTHA <br />2128 100TH ST SE <br />EVERETT WA 98208-3835 <br />PHONE: 4252327729 <br />SITE ADDRESS: 2128 100TH ST SE <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 for Development. <br />3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 ; .� <br />r:= <br />' , „�.:,: <br />4. Re-paving of driveway shall match existing limits of existing driveway and shall be <br />�_, <br />paved up to roadway paving. <br />5. Contact the City of Everett Public Works Inspector Jim Knappert at 425-339-7404 _ <br />prior to starting construction and with other inspection requests. <br />6. Install erosion control measures per City of Everett Standards for small parceis and <br />remove upon completion of the project prior to final approval of the permit. :: <br />__, ,-. <br />7. Keep City streets clean at all times. No dirt, mud, rocks, or debris to be tracked onto ' <br />roadway. <br />8. Protect all existing underground utilities during construction. , -- <br />,; '� <br />,:�. ,�t .�,. <br />Public Works Permit Fee Breakdown: <br />Paving (Driveway & Parking Area)............$45.00 <br />PW Site Inspection ....................................$20.00 <br />pproved for C struction <br />�l \1 _ <br />F1�3AL INSPECTI'�N� <br />Approved as Constructed <br />�� <br />Date <br />� �� —� <br />Date <br />1'.�' yr•, �� ..c�. <br />�i � ' �ry, <br />.: -; 4,�,;� ;..... := � <br />....,,- <:: :_ <br />. :� :: : ,; <br />_� :.; -: ._- <br />� <br />O <br />E"', <br />� <br />O <br />� <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 />�`j causes of action that may arise because of installation and maintenance of the <br />— improvement or other right-of-way use hereto applied for and further agrees to <br />remove same upon notice from the City and to replace public property <br />damaged thereb,y:� _ <br />nature of App�icant <br />�� <br />SC���� <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 COMPLEfION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />��� <br />