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PUBLIC WORKS PERMIT Date:
<br />Public W�rks Permit #:
<br />City of Everett Public Works Department �
<br />� - 3200 Cedar Street , Buildinq Permit #;
<br />� Everett, WA 98201 ,
<br />(425) 257-8810 Planning Reference #:
<br />Public Works Fee $:
<br />Other $:
<br />OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS:
<br />BELMARK LLC
<br />4229 76TH ST NE STE 105
<br />MARYSVILLE Wq 98270
<br />PHONE: 3606533634
<br />TAX PARCEL ID # 00571700400400
<br />DESCRIPTION OF PROPOSED WORK:
<br />PUBLIC WORKS FOR NEW HOUSE
<br />SS 1202-2014-006
<br />PHONE:
<br />SITE ADDRESS: 5107 SOUND AVE
<br />3/13/2015
<br />PW 1503-014
<br />C1502-011
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<br />$ 65.00
<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. Connect side sewer per City Standard #'s 601, 602, 604.
<br />5. The contractor must meet with the Public Works Inspector to discuss the storm wate. r system :prior. to,.beginni�g
<br />the project. Call Randy Allen at 425-339-7403. , _ , ; w
<br />6. Remove erosion control measures upon completion of the proj�cti pnp,r t,o fin�l ��ipr�oval �#' q1� ;�ermit.: ,; �""�
<br />7. No dirt, mud, rocks or debris to be tracked onto roadway. �-�-�'-� � �-��� � �-` ~
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<br />Ap "ov�i fqr Con�tlp�
<br />INAL IN�ECTION
<br />Approve as Constructed
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<br />Date
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<br />Date
<br />ACKNOWLEDGEMENT OF CONDITIONS
<br />The undersigned owner/applicant 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 same upon notice from the City and to replace
<br />public property damaged thereby.
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<br />Signature o 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 PRO]ECT OVER 90 DAYS DURATION.
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