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f. <br />� � Q�i :�L��.� <br />R• <br />PUBLIC WORKS PERM�T <br />City of Everett Pubhc Works Departmenl <br />3200 Cedar Slreet <br />Everett, WA 98201 <br />(425)257-8810 <br />Date: <br />Public Works Permit #: <br />Buildinp Permit #; <br />Planninc7 Reference #: <br />1l4l2011 <br />PW 1101-001 <br />Public Works Fee $: $ O.OQ <br />Other $: <br />OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br />CITY Of EVERETT CRANE PAl1L <br />3200 CEDAR ST <br />EVERETT �l�Iq 98201 <br />PHONE: 42525780�� PHONE: 4252578949 <br />TAX PARCEL ID # 29052100300800 SITE ArDRESS: 4015 RAILWAY AVE <br />DESCRIPTION OF PROPOSED WORK: <br />IMPORT DREDGE MATEftIAL ON CITY SITE <br />-A PORTION OF WORK COVERED IN SEPA09-041 < 1 ACRE AREA <br />PERMIT CONDITIONS <br />1 All calls for inspection shall be made 24 F;nurs in adoance. <br />2 All work shall be performed in accordance with the permil and current Citv of Everett Oesign and Construction Standa�ds <br />and Spediica6ons <br />3. Call Location Underground 5ervice 48 hrs before you dig. TOLL FREE NUMBER 811 � <br />-Keep City streets clean at all times <br />-Provide sdt fence around river side of earthwork placement Provide adddionai erosion control measures as <br />needed <br />-Area (or this work (under one acre) must be designated in the field <br />�liS/J___'`�%OD�i2� � �� —�/ <br />Appro ed for Construction Date <br />FINAL INSPECTION Date <br />Approved as Construcled <br />W <br />H <br />rr <br />� <br />m <br />� <br />h <br />� <br />� <br />0. <br />ACKNOWI EDG[MENT OF CONDI110NS <br />Thc undcrsiyned owner/apphcant here uy agrces �o hold and <br />save h. rmless Ihc City o( Gveretl irom any and all daims lor <br />damages, costs, expenses, or causes of action Ihat may arise <br />because of mstallaGon and mainlenance ol tl�e im.provemenl <br />or olhcr right-ol way use hereto applied loi anJ furiher agrces <br />to remove samc upo noUce Irom Lhe Gty and lo replace <br />pubhcp�yda d ed`�rql'iy. n <br />/ {' <br />Signa(ure of <br />/—�/�/,� <br />Da1e <br />WORK AUINORI7FD BY THIS P[RMlf MUST O[ STARTED WRIIIN 180 DAYS OF D�TE P[RMR IS ISSUED ARA'NEREAfTER IS TO �E DILIGENTIY <br />PURSUFD 1�0 COMPLLI ION. THIS PCRldll MAY F3C UNCI:LL[D UV THE CITY UPON ANY SiOPVAGE OF WORK Ofv THIS PHOJE(7 OVER 90 DAYS DUHA��ION <br />