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i � <br /> PUBLIC WORKS PERMIT Date: 11/3/2011 <br /> Publ�c Works Pertnk#: PW1111-0OS <br /> City of Evereri Public Works Department guildin Pertnft#; <br /> 3200 Cedar Street 9 <br /> Everett, WA 96201 Planning Reference#�: <br /> (425)257-8810 <br /> Public Works Fee$: $ 104.00 <br /> o- <br /> Other $: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND AD[)RESS: <br /> BLACK DOG INVESTMENTS LLC ROSS JAMESOIQ <br /> 2505 113TH ST SE 425-257-9030 <br /> EVERETT WA 98208 <br /> PMONE: PHONE: <br /> TAX PARCEL ID N 00437381802200 SITE ADDRESS: 3422 BROr�DWAY <br /> DESCRIPTION OF PROPOSED WORK: <br /> PAVE FOR PARKING LOT,ADD LANDSCAPING &CATCH BASIN <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 Evereri Design and Construction Standards <br /> and Specifications. <br /> 3. Call Location Under�round Service 48 hrs before you dig. TOLL FREE NUMBER 611 <br /> '- <br /> 4. Per Planning, one tree is required to be planted in the front. Please call Teresa Fimstahl at 425-257�7281 to �" W <br /> schedule a landscape i�,pection. _, _ ' ��' <br /> 5. No dirt, mud, rocks or debris to be tracked onto roadway. �� "_- _-» E"� <br /> 6. Pave to existing paving in alley. ? '-'�i:- � <br /> �,-_,_. <br /> Please call Randy Allen a1425339-7403 to schedule Putrlic Works inspections. '.' ," . O <br /> � <br /> f�-s �aw aJ.�oec� P(2�K �f'� �c-i4-zoc r _ � �' ~, <br /> � z <br /> � o..,�� <br /> I ; V� ,_,r, _ _ o ; <br /> �_ _ a <br /> TO POS i�ING �� ��_ IZ ACKNOWLEDGEMENT OF CONDITIONS <br /> - The undersigned owner/applicant hereby agrees to hold and <br /> save hartnless the City of Everett from any and all Gaims tor <br /> damages,costs,ezpenses,or causes oi adion that may arise <br /> because of installation and main!enance of the improvement <br /> �fL�.� � I" ������ or other right-of-way use hereto applied for and further agrees <br /> A r e for Constru Date to r�move same upon notice from the CRy and to replace <br /> PP /9 public property damaged thereby. <br /> � ��� 2 — S - � .ti — � � �� � �'� �� <br /> INAL INSP TIGN ate <br /> Approved as Constructed Signature of Applican Date <br /> WORK AUTHORIZED BY THiS PERMIT PIUST BE STARTED WITHIN 180 DAYS OF DATE PERMR IS TSSUED AND iNEREAFfER I�TO PF DlilGENTLY <br /> PURSUED TO COMPLETION. THIS PERD717 MAY BE CANCELLED BY 11iE CiTY UPON ANY STOPPAGE OF WORK ON THIS PRO]ECT OV[R 90 DAYS DURATION. <br />