3024 BELMONTE LN 2017-01-13 - Laserfiche WebLink

�� �� T . � � ?" PIJBLIC WORKS PERMIT City of Everett Pubiic Works Department 3200 Cedar Street Everett, WA 98201 (425) 257-8810 Date: 7/23/2013 Public Works Permit #: PW1307-013 Building Permit #; Planning Reference #: Public Works Fee $: $ 45.00 Other �: OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: DEPARTMENT OF ECOLOGY DEPARTMENT OF ECOLOGY 1101 S FAWCETT AVE SUITE 200 1101 S FAWCETT AVE SUITE TACOMA �/�/q 98402 ��OMA WA 98402 PHONE: 2533834940 PHONE: 2533834940 TAX PARCEL ID # SITE ADDRESS: 3024 BELMONTE LN DESCRIPTION OF PROPOSED WORK: GROUND WATER MONITORING WELL-DEPT OF ECOLOGY 1 SOIL BORING FOR DEPT OF ECOLOGY (LLMW-350) TO INSTALL PERMANENT GROUNDWATER MONITORING WELL IN THE RIGHT OF WAY BETWEEN 3024 & 3030 BELMONTE LN. PERMIT CONDITIONS 1. All calis for inspection shall be made 24 hours in advance. 2. All work shall be performed in accordance with the permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 r- 4. Traffic controi shall be City of Everett/MUTCD standards. 5. Install monitoring well per standard drawing 312 and 316. 6.Contact City of Everett inspector Randy Allen 425-339-7403 prior to starting construction �''' ��5 �� - �:,� �__; �u�-, � 2 20�3 .� t�� :`�'i',��,.�..; � � i Y _ i, , i _..._ _ _�.,�;�t�� ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harmless the City of Everett from any and all claims for damages, costs, expenses, or causes of action that may arise because of installation and maintenance of the improvement or other right-of-way use hereto applied for and further agrees to remove same upon notice from the City and to replace public property dama ereby. /, � � ` =/� � "'r.'l�'� �-✓ Signature of Applicant Date 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. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.