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PUBLIC WORKS PERMIT Date: 9l26/2013 <br /> r � Public Works Permit #: PW1309-023 <br /> City oF Everelt Public Works Department <br /> = �y , �$� 3200 Cedar Slreet Buildinq Permit #; B1309-038 <br /> Everett, WA 98201 Flanning Reference#: <br /> (425) 257-8810 <br /> Public Works Fee $: $ 65.00 <br /> �ther $: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> JORGENSEN TRAVIS <br /> A710 GARDNER AVE <br /> EVERETT Vyq 982G3 <br /> PHONE: 2063079531 PHONE: <br /> TAX PARCEL ID p 00417400003100 SITE ADDRESS: 4710 GARDNER AVE <br /> DESC�4IPTION OF PROPOSED WORK: <br /> PUBLIC WORKS FOR DETACHED GFlRAGE <br /> PERMIT CONDITIONS <br /> 1. All calis for inspection shall be made 24 hours in advance. <br /> 2. All work shall be pertormed in accordance wi�h 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 The contractor muet meet with the Public Works inspector to discuss potential drainage routing prior to <br /> beginning the project. Call Randy Allen at 425-339-7403 //Call Clifi Lindman at 425-339-7404. <br /> 5. No dirt, mud, rocks or debris to be iracked onto roadway. �;, �W <br /> 6 Pave driveway from lhe front property line out to the streel paving. �—�--�-- �--�--.— � �t'� <br /> —��,�,eaxcox� —' F�r <br /> C)r-� c.. r� -- (/] <br /> r c�o� 'o` <br /> i+ ... c � � <br /> d c`n�'�-m �i <br /> 0 <br /> o � �O <br /> � m cl� <br /> � c �� c � <br /> � � <br /> U' !� �A(T[1 m j� � <br /> � f`�f`.')!"�..1 V{n H�v'� <br /> vt�O G L i�-._.L,�--�r. � <br /> O• ��'' <br /> �]�G�Ut O`�1N �� `� <br /> tL <br /> 1-• S.` <br /> �CKNOWLEDGCIdC-NT OF CONDITIONS <br /> The undersigned owner/appticant hemby aqrces lo ho�d and <br /> save harmless Ihe City of Gverett from any and all claims for <br /> damages, costs, expenses, or causes al ac�ion that may arise <br /> y 6ecause of inslallahon and maintenance of the improvement <br /> �i/ _ ���� or olher right-ol-way use herclo applied for and further agrees <br /> Ap o d r Con Ctio Date to remove same upon nolice frorn Ihe City and to replace <br /> public properly damaged Ihereby. � <br /> - �'� �'- �� <br /> INAL IN E TI N Date � ��/�f��i <br /> Approved as Construcled SignaWre of Appiicant Datc <br /> WORK AUIHORIZED HY TMIS PERMR MUST BE STARTED WRHIN I80 DAYS Of DATE PERMif IS ISSUED AND THEREAFTER IS TO�F DILIGEtJTLY <br /> PURSUGD TO COMPLE170N. THIS P[RMIi�MAY OE CANCELLFq AY THE CIIY UPON ANY STOPPAGG OF WORK ON THIS PRO]FCT OVER 90 DAYS DURATIOPI. <br /> I � <br />