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PUBLIC WORKS PERMIT Date: 12/2/2015 <br />Public Works Permit #: PW1512-007 <br />City of Everett Public Works Department <br />3200 Cedar Street Building Permit #; C1509-007 <br />Everett, WA 98201 Planning Reference #: SS07-026 <br />(425) 257-8810 <br />Public Works Fee $: $ 85.00 <br />Other $: <br />OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br />POHLAND TODD & HOLLY <br />314 HEATHER ROAD <br />EVERETT WA 98203 <br />PHONE: 4253459003 <br />TAX PARCEL ID # 00392000000602 <br />SITE WORK FOR NEW SFR <br />POI-ILAND TODD & HOLLY <br />314 HEATHER ROAD <br />EVERETT WA 98203 <br />PHONE: 4253459003 <br />SITE ADDRESS: 7114 BEVERLY LN <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 />. ., <br />, ,_ ., _.,. ,. _ ;.... . _ <br />, , _ <br />4. Site Civil Work to be done per plans approved by the City of Ever�tt Pub{i� WG2rks,Q�par���r�t�ia�ec� _12/9/20�?'5 <br />5. Contact the City of Everett Public Works Inspector Jim Knapperfi �t 4�5 33� =740�;prior #�g;���[�g �pr�5tructi�n <br />-.-, „ <br />and with all other inspection requests. See attached to request an inspe�#tork= � °'=' `` <br />iTi <br />� _' i <br />6. Connect side sewer per City Standard #'s 601 through 604 ;:,; ;;--�s <br />7. Any damage to the City Sidewalk or other improvements shall be re.placed at the direction of th� City Public `� <br />Works Inspector. ��a�;r __ <br />8. Keep City streets clean at all times. No dirt, mud, rocks, or debris ta��be tracked onto roadway. ' <br />9. No building materials to be stacked on sidewalk/roadway and sidev�';''alk/roadway to be kept clean and open for <br />peclestrian traveL - _ ' " '°` ` � `` <br />10. Install erosion control measures er Cit of Everett Standards fQ �'� , <br />P Y r �s rr��l I; �a#'�el5 ; � � `' � � � � � � ,. � <br />11. Remove erosion control measures upon completion of the pro�eCt,��radr to fina� ap��v�l'c�f th���t'rrt'[#.� � r� � <br />, <br />, , <br />, .,i,; ..__> __, ,.._., : ,:::_:, ..� .. .... ..:.�. ,., :_.. _�, _,-. - <br />_. ;:.: '� 0 <br />_: ; ,�- <br />. <br />�_ � Q-I <br />� <br />_;;, <br />;:.;::, <br />Public Works Permit Fee Breakdown: <br />Concrete Paving $45.00 <br />PW Plan Review $20.00 <br />PW Site Inspection $20.00 <br />� <br />.�'��'�a. �_���� �� � �O�S <br />, Approved for Construction Date—'— <br />FINAL INSPECTION Date <br />Approved as Constructed <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/appiicant 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 />or other right-of-way use hereto applied for and further agrees <br />to remove sa �u on notice from the City and to replace <br />public pr erty d age ereby. <br />r�j�� �r j� - <br />i <br />Signature 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 DILIGENTI_Y <br />PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CI7Y UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />F�,G � <br />