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P'UBLIC �ORKS PERMIT <br />City of Everetl Public Works Depar�men; <br />3200 Cedar Street <br />Everett. WN 98201 <br />(425�257-E810 <br />� Date 9l22/2014 <br />Pubfic Works Permd # PW i409-024 <br />Buildinq Permit #, <br />Plannmp Reference # <br />Public Works Fee S S 50 UO <br />Other 5 <br />OWNER NAME AND ADDRES9 APPLICANT NAME AND ADDRESS <br />GUSTAFSON, UENNIS E DENNIS GUSTAFSON <br />GUSTAFSON KATHLEEN L 1275 MADRONA AVE <br />EVERETT WA 98203-173? EVERETT WA 98203 <br />PHONE: PHONE: 4253391576 <br />TAX PARCEL ID iJ 00505700003702 SITE ADDRESS: 1215 �J�ADRONA AVE <br />DESCRIPTION OF PRUPOSED WORK: <br />EFOSION CUNTROL <br />PERtv11T CONDITIONS <br />t All calis (or �nspection sh�ll be made 24 hours in advance. <br />Z All work shall be performed in accerdance with ihe permit and current City of Everetl Design and Construction Standards <br />and Specificat�ons <br />3 Catl Localion Underground Service 48 hrs before you dig TOLL FREE NUMBER 811 <br />4 All work shall conform to the reqwrements of the Nelson Geotechnical Assouates. Inc., Landslide Evaluation <br />Letter, Gustafsen Property, prepared for Dennis and Kathy Gusta{son, NGA Fde No. 872913, dated April 12, 2013, <br />and also the Nelson Geotechnical Associates, inc , MEMORANDUM, dated November 1, 2013 signed by Khaled M <br />Shawish, P.E. <br />, Keep city slreets clean al all times dunng construction Any trackout of dirt or debns must be cleaned by <br />sweeping immediafely. <br />Your Public VVorks Inspecter is Randy Allen He can be reached at 425-339-7403 to schedule inspections or for <br />consultation. <br />App o fo Cons <br />INAL INS CTION <br />Approved as Construcled <br />Da:e <br />Zr��._%S <br />�ale <br />�J- S� T l.�p-G� l -Z�i - / � <br />ACKNOWLEDGL=tv1[N 1 OF CONDITIONS <br />The undersignedownerlapplicant hereby agrees to held and <br />save harmless Ihe Cily of Everelt (rom any and all clamu for <br />damages, costs, expenses,or causes of act�on that may an;e <br />becauseof inslallalionand ma�ntenance ol the improvement <br />or olher right-of-way usehereto applied for andfuriher agrees <br />to remove same upon nolice from the City and to replace <br />pubP.� property damzged ihereby <br />SignaWre o� ^^phcaN <br />Date <br />N'ORK AUTHORI2ED BY THIS PERNIT 1•1UST BE STARTED WITHIN 180 DAYS OF DATE PERhllT I� ISSUED ANU THEREAFfER IS TO �3E DILIGEP;7�Y <br />PURSUED TO COMPLETIO�`1 � HIS PERMR MAY BE CANCELLED BY TH[ CI71" UPON ANY STOPPAGE OF NJORK ON THIS PRO]ECT OVER 90 DAVS UU�J�TION, <br />