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P�UBLIC�'ORK.� PERM17 Uate: <br />� Fubli J�lorks Permit # <br />City of Everetl Public Works Department <br />.� T, �� 5200 Ceciar Street Buildinq Permit #', <br />.h ��`'�'' ° Everett, WA 96201 Planninp Reference #: <br />(425) 257-U8�0 <br />Public Works Fee �: <br />Other S: <br />UWNER NAME AND AU�RESS: APPLICP.NT NAME ANU AUDRESS: <br />PARAGAS. AERGN ANDR[W F �T PARAGAS, AERON ANDREVJ F <br />1U031 MONTANA RD <br />EVERETT Wq <br />PHONE: 20632703G3 <br />98204-8709 <br />TAX PARCEL ID # 00557.4D0700900 <br />NEW ASPHALT PAVING <br />864SF NEW ASPHALT PAVING OVER EXISTING GR4VE! <br />10031 MONTANA RD <br />EVERETT WA A8204-8 <br />PHONE: 2063270363 �09 <br />SITE ADDRESS: 10031 MONTANA RD <br />10/19I2015 <br />P W 1510-032 <br />� 65.00 <br />I COR OF SD LOT 9 TH NVVLY TO 7P8 <br />/11�/! 60T 2 9f Sful(-1 83rRE� �FAJ- <br />PERMIT CONDITIONS 8303020i61 <br />� AII calls for inspection shall be made 24 hours in advance <br />2 All work shall be performed in accordance wdh lhe permd 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 8' 1 <br />�; <br />1 P:o dirt, mud, rocks, or debris to be tracked onto roadway. �� � =� <br />_, <br />lJ� ��' . <br />5 Install erosion conUol measures per City of [verelt Standards for small parcels or as ics(�ucte�c{ by tlui`Public <br />Workslnspector. "`� - <br />�.{ <br />6 Contact the City of Everett Public Works Inspector Jim Knappert at 425-339-7404 prior to starting construcbon <br />and wilh other inspection requests <br />Public Works Permit Fee Breakdown. <br />Asphalt Pawng $45.00 <br />PW Site Inspection $20 00 <br />-•{ <br />i. <br />� <br />� <br />, �. <br />� <br />U� <br />U• <br />� ° r.> r <br />�n � c. �n <br />x;CJ,-,o _ <br />, o r� �; <br />—� .. � <br />`�i <br />�_.. �.� <br />ACKNOWL[DGE-MGNT- O(` GONDITIONS <br />The undersigned owner/applicanl hereby agrees lo hold and <br />savc f armless ihe Gty of [verett from any and all damis (or <br />damages, costs, expenses, or causes ol action Ihat may arise <br />because ol installation and maintenance ol the improvemenl <br />or other riqht-o6way use hereio applied for and lunher agrees <br />lo remove same upon no6ce from the City and to replace <br />public p�roperty damaged Ihereby. <br />� <br />, �j � l� �i, <br />Si�a/ ure o Applicant Date <br />WORK AUTHORIZ[D 6Y TH15 PERtdIT P1U5T BE STARTED WITHIN 180 DAYS OF DATE PERt•i1T IS ISSUEU AND THEREAF7ER IS TO BE DILIGENTLY <br />PURSUED 70 C01•iPLEIIOV. THIS PERh11T NAY BE UNCELLED BY THE CI'TY UPON ANY STOPPAGE Of WORK ON TH15 PRO7ECT OVLR 90 DAYS DURATION. <br />/�1 L Q <br />