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� PUBLIC WORKS PERMI'1' <br />City of Everelt Public Works Department <br />�,,� _ �� 3200 Cetiar Street <br />�=� `�i2��'-' Everett, WA 98201 <br />(425) 257-8810�`��_. <br />OWNER NAME AND ADDRESS: <br />EASELY TOM <br />819 HOYT AVE <br />EVERETT WA 98201 <br />PHONE: 2069546948 <br />PARCEL ID # 00553216801100 <br />Date: <br />Public Works Permit #: <br />� Buildinp Permit #; <br />Plann�ng F'�ference#: <br />Public Works Fee $: <br />Other $: <br />�� IAPPLICANT NAME AND ADDRESS: <br />HOLMSTADS PLUMBING INC <br />PO BOX 5635 <br />DESCRIPTION OF PROPOSED WORK: <br />CUMPLETE SEWER SERVICE FROM HOUSE TO 8" MAIN <br />WORKING IN RIGHT OF WAY <br />EVERETT WA 98206 <br />PHONE: 4252599131 <br />SITE ADDRESS: 819 HOYT.iVE <br />12I2212011 <br />P1N1112-009 <br />$ 30.00 <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 48 hrs before you dig. TOLL FREE NUMBER 811 <br />4. Connect side sewer per City Standard #'s 601, 602, 604. <br />5. Install erosion control measures as determined by the Public Works inspector, such as silt fence, straw bales, W <br />swales, or erosion blankets. �r <br />6. Remove erosion control measures upon completion of the project prior to final approval of the permit. F,,� <br />Z No dirl. mu�. rocks or debris to be tracked onto roadway. � <br />YOUR PUBLIC WORKS INSPECTOR IS RANDY ALLEN-HE CAN BE REACHED AT 425-339-7403 <br />� <br />0 <br />g <br />z <br />0 <br />H <br />� <br />0 <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned ownerlapplicant hereby agrees lo hoid and <br />save harmless the City of Everetf from any and all claims tor <br />damages, costs, expenses, or causes ot aclion thal may arise <br />because of installation and maintenance of the improvement <br />1 or other right-of-way use hereto applied for and further agrees <br />� "��– to remove same upon notice from ihe City and to replace <br />Appr e r C nslfu Date public propeAy damaged �hereby. <br />�_ �'2—�2 � G C ��" ��+"�� <br />✓ <br />FI AL INSPEC ION Data <br />Approved as Constructed SignaWre o pplicant Date <br />WORK AUTHORIZED BY THIS PERMIT i4USf� BE SiARTED WIfHIN 180 DAYS OF DATE PERMR ISSUED AND REAFfER 15 TO BE CILiGEYTLY <br />PURSUED TO COMPLEf10N. THI`� PERM[T MAY 6E CANCELLED 8Y THE CTfY UPON ANY STOPPAGE OF WORK ON TH[S PROJECi OVER 90 DAYS DUFATI� <br />