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--, PUBLIC WORKS PERMIT Date: 12/15I2014 <br /> /;. , Public Works Permit #: PW1412-064 <br /> City oF Everelt Public Works Department <br /> — � 3200 Cedar Street Buildinp Permit # <br /> � ��"� Everett, WA 98201 Planning Reference # <br /> (425) 257-88i0 <br /> Public Works Fee 5, 5 25.00 <br /> Other 5: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> BRIAN PETERSON(KROGER) TH[ RILEY GROUP(KRISTIN) <br /> 3701 S NORFOLK ST#301 17522 BOTHELL WAY NE <br /> SEATTLE WA BOTHELL WA 98011 <br /> PHONE: 2068080303 PHONE: 4254i50551 <br /> TAX PARCEL ID i7 SITE ADDRESS: 2201-2213 EVERETT AVE <br /> DESCRIPTION OF PROPOSED WORK: <br /> GROUNDWATER SA�viPLING <br /> (12I15/2014 10 32 AN1 BES) <br /> GROUNDWATER AND SOIL SAMPLING IN THE RIGHT OF WAY <br /> PERMIT CONDITIONS <br /> 1. AII calls for inspection shall be made 24 hours in advance. <br /> 2 All work shall be performed in accordance wdh tne permit and current City of Everett Des�gn and Consiruction Standards <br /> and Specifications. <br /> 3 Call Locahon Underground Service 48 hrs before you dig TOLL FREE NUMBER 611 <br /> 4 Sample collection localions shall have at least 5'(fwe feet) seperat�on 1rom Everett public utilil�es �, 3 ��—, <br /> 5 Sidewalk shall not be closed for th�s pro�ect Please supply trafiic control plan �f there is a need to close the —. . � <br /> sidewalk a r� � <br /> 6 Contact the City o(Everett Inspector Randy Ailen 425•339-7403 0 'r �, � <br /> pnor�o starting construdion �� � <br /> - a..... <br /> � ��� <br /> i <br /> � <br /> r�� <br /> G� <br /> � r � <br /> VI � <br /> �� � � <br /> ��1 O V1 � <br /> �0�: ����� <br /> �_ _ n��`Yl <br /> r� O� F'. ^ <br /> 1� <br /> ACKNO'NL�i)GEF.tFNT Of CONDITIONS <br /> The undersigned o�•medapplicant here6y agrecs to hold and <br /> save harmless lhe C�ty ot Everell from any and all daims for <br /> damages, cosls,ezpenses, or causes of action Iha1 may anse <br /> � because of installa�ion and maintenance of Ihe improvement <br /> z � � or olher right of-way use hereto applied for and furiher agrees <br /> A r for Con uCC Dal lo remove same upon notice(rom the City and to replace <br /> pubhc propeAy damaged lhereby. <br /> , � z _ � —7 <br /> FINAL INSP C I Date � �" � ',� � I �j I r/� L� <br /> Approved as ConstruCted SignaWre of Applicant Dale <br /> VJORK AUTHORI2[D UY iH15 PERh1fT h1U5T BE STARTED 1NRHIN I80 DAYS OF DATE PERhIIT IS ISSUE�AND TH[REAFTER IS TO DE DILIGENTLY <br /> PURSl1ED TO COh1PLET10N. TNIS PERtdif MAY BE CANCEIIED BY THE CIl'1'UPON ANY STOPPAGE OF l`JORK ON THIS PRO7ECT OVER 90 DAYS DURATION. <br /> � Vl� <br />