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PUBLIC WORKS PERMIT <br />City of Everett Public Works Oepartment <br />3200 Cedar Street <br />Everett, WA 98201 <br />(425) 257-8810 <br />Date: <br />Public Works Permit #: <br />Buildinq Permit #; <br />Planninq Refe�ence #: <br />7/22/20G8 <br />PV110807-020 <br />Public Works Fee $: $ 50.00 <br />Other $: <br />OWNER NAMEAND ADDRESS: APPLICANT NAME AND ADDRESS: <br />BERGSAGEL CONSTRUCTION OWNER <br />11122 27TH OR SE <br />EVERETT Wq 98208 <br />PHONE: 4257727532 PHONE: <br />TAX PARCEL ID # 29053000303000 SITE ADDRESS: 3903 FEDERAL AVE <br />DESCRIPTION OF PROP.OSED WORK: <br />INSTALI 6" SEWER LINE FROM MAN HOLE IN ANGLE <br />LANE TO LOT 1 8 2 AT 3903 FEDERAL AVE <br />PERMIT CONDITIONS <br />1. All calls for inspec�ion 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. Side sewers to be installed per city standards 602, 604, 601 <br />5. Bedding for lhe trench to be done per City Standard #611. Restoration to be done per Standard #610 and #316 <br />6. install ciean out every 100 feet -n <br />7. Restore buffer area ro original condition after construction of houses is complete � <br />r- r �= <br />8. Meet with Public Works Inspector on sile to determine the extenl of concrete panel replacement needed .—, <br />_��� o <br />FOR PUBLIC WORKS INSPECTIONS CALL RANDY ALLEN AT 425-339-4403 � � � c <br />G <br />r.� <br />_ G <br />��� <br />� <br />' ��_ 7z o8 <br />Appr ed for Construction Da <br />3: <br />2 <br />m <br />� <br />� <br />W <br />H <br />HI <br />� <br />� <br />0 <br />� <br />z <br />0 <br />� <br />° <br />ACKNO'NLEDGEMENT OF CONDITI�7N5 <br />The undersigned owner/applicant hereby agrees to hold and <br />save harmless the City of Everetl from any and all claims for <br />damages, cosls, expPnses, or causes of adion thal may arise <br />because of installation and maintenance oi ihe improvemen� <br />or other right-of•way use herelo applied (or and further agrees <br />lo remove same upon notice (rom lhe City and lo replace <br />pubiic property damaged ihereby. <br />Z ob' <br />ignature of Applicant Dale <br />WORK AUTHORIZED BY THIS PERMIT hiUST BE SrARTED WITHIN 180 DAYS OF DATE PERMIT 15 ISSUED AND THEREAFTER IS TO BE �ILIGEMlY <br />PURSUED TO COMPLEf10N. THIS GERMIT� MAY BE CANCELLED BY TNE CiiY UPON ANY STOPPAGE OF WORK ON TMIS PROJECT OVER 90 DAYS DURATION. <br />TQ POSTING ��_ �� � <br />