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PUBLIC�ORKS PERMIT � Date: 7/21/2016 <br />Public Works Permit #: PW1607-038 <br />City of Everett Public Works Department <br />3200 Cedar Street Parent Permit #: BW1606-004 <br />Everett, WA 98201 Planning Reference #: <br />(425) 257-8810 <br />Public Works Fee $: $ 90.00 <br />Other $: <br />OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br />MUDALIAR SELVA L <br />1336 MADRONA <br />EVERETT Wq 98203 <br />PHONE: <br />TAX PARCEL ID # 00505700002102 <br />VALENCIA GONZALO <br />PHONE: 2536398909 <br />SITE ADDRESS: 1336 MADRONA AVE <br />INSTALL PRIVATE DRAINAGE SYSTEM AND REPAVE/REPAIR DRIVEWAY <br />THIS WORK DONE TO ELIMINATE DRAINAGE PROBLEMS ALONG DRIVEWAY AND AROUND HOUSE. <br />THIS PERMIT INCLUDES THE WORK NECESSARY TO REPAVE THE DRIVEWAY DOWN TO MADRONA AVE AND <br />RESTORE THE AREA AROUND THE DRAIN PIPE EXCAVATION. <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hours in advance. <br />2. Ali 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 />4. Contact the City of Everett Public Works Inspector Randy Allen at 425-339-7403 prior - <br />to starting construction and with other inspection requests. See attached to request an -�_; -� �_� ;:_, �' ` <br />inspection. _ �" —''_, :`- w <br />T t-i i '� <br />r.-a -r� fi`I '-: <br />5. Keep City streets ciean at all times. No dirt, mud, rocks, or debris to be tracked onto ,:��'�-'- '�' �' ` '�:` �I <br />roadway. °- �i <br />6. Install erosion control measures as determined by the Public Works Inspector, such - � <br />as silt fence, straw bales, swales, or erosion blankets. -'� <br />7. Drain Water shall be collected around house using perforated pipe, discharged down <br />driveway in solid pipe such as PVC ASTM D3034 SDA 35 or ADS N-12 or approved � <br />equal, then connected to the storm drain pipe in Madrona. � <br />8. It is the applicant/owner's responsibility to ensure that stormwater runoff from new _� ��; f°'; ;;' ��; Z <br />irnpervious surfaces will be managed on-site in a manner that does not adversely affect ''��`"' _""' ��"�� `" <br />- , ;-, , :-:, ; � <br />neighboring properties, including the City's right-of-way and/or easements and the - <br />improvements located therein. . � <br />Public Works Permit Fee Breakdown: <br />Driveway / Asphalt .......................................$25.00 <br />Misc. Minor Permits (Drainage Work)....$25.00 <br />PW Plan Review ...........................................$20.00 <br />PW Site Inspection ......................................$20.00 <br />� <br />� <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 />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 thereby. <br />� —, �� . � <br />� % - <br />�� � �,:�i� •� _ . -i../r„- %� / / <br />--. •� l; <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 DILIGENTLY <br />PURSUED TO COMPLEfION. THIS PERMIT MAY BE CANCELLED BY THE CI7Y UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />