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' PUBLIC WORKS PERMIT Date: 6/24l2013 <br /> _ City of Everett Pubiic Works Department Public Works Perntit#: PW1305-010 <br /> 3200 Cedar S;�eet Buildinp Permit#; <br /> � Everett, WA 98201 Planninq Reference#: <br /> (425)257-8810 <br /> Public Works Fee S: $ 45.00 <br /> Other S: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> DONALD F�)RSYTHE FRANCES �ORSYTHE <br /> 7210 HIGHLAND DR SAME <br /> EVERETT WA 98201 <br /> PHONE: 4252G70820 PNONE: <br /> TAX PARCEL ID# SITE ADDRESS: 2720 EVERETT <br /> DESCRIPTION OF PROPOSED WJRK: <br /> REPAIR SIDE SEWER <br /> (5/24l2013 3:52 PM DES) <br /> REPAIR SIDE SEWEF AND REPAIR ASPIIALT IN THE ALLEY <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 46 hrs before you dig. TOLL FREE NUMBER 811 <br /> 4. SEWER CONNECTION PER CITY STANDAf�D�612 <br /> 5. REPAIR ALLEY PER CITY STANDARD#31G. - ; G7 ;:; <br /> 6. P��?TRAFFIC CONTOL SIGN PER MUTCD STANDARD. DO NOT BLOCK ALLEY FOR TRAFFIC, 012 •�.; � �W <br /> COORDINATE WITH NEIGHBOURS TO TAKE T[MPORARYALTERNATE ROUTE. i,�;=!� _. ' E•1 <br /> 7. CALL CITY INSPECTOR RANDY ALLEN 425-339-7403 OR == ? H <br /> CLIFF LINDMAN 425-339-7404 PRIOR TO CONSTRUCTION. �' � •-; � <br /> �=; <br /> � ��iQ <br /> � , <br /> �-- �.p.,� <br /> �� <br /> � i'O <br /> , `� <br /> c.�n p V <br /> �a43 �,.� <br /> ��r <br /> _,�___ <br /> '� a, .;� <br /> ACKNOWLEDGEMENT Of-CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and <br /> save harmless Ihe City of Everett(rom any and aIl claims for <br /> � damages,cosls,expenses,or causes of action that n�ay arise <br /> because of installalion and mainlenance of lhe improvement <br /> S �� or other righFo(-way use hereto applied(or and furiher agrees <br /> pp d r C nstr � / p to remove same upon nolice from the Ciry and to replace <br /> r public property damaged lhereby. <br /> <�.�� ,� � --,�--� , �<..� �3E�20 <br /> INAL INSPE TI N � Date � �' <br /> Approved as Constructed Si�nature of Applicant Date � <br /> WORK AUT110RIZED 6Y THIS PER�fIT t•fUST BE STARTED lyfTlilN 180 DAYS OF DATE PERPtiT IS ISSUED AND 1}IEREAFf[R IS TO BE DILIGEN7LY <br /> PURSUED TO COI•1PLETION. THIS PERPIIT h1AY OE CANCELLED 6Y THE CIiY UPON ANY STOPPAGE OF VJORK ON THIS PROJECi OVER 90 DAYS DURATION. <br />