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PUBLIC WORKS PERMIT <br />City of Everett Public Works Department <br />�L 3200 Cedar Street <br />Everelk; WA 98201 . <br />(425) 257-8810 <br />_ ��r': <br />OWNER NAME AND ADDRESS: <br />HAACK BROS CONST INC <br />3922 87TH AVE NE <br />MARYSVILLE WA 98270 <br />PHONE: 4253342790 <br />AX PARCEL ID # 00552400601400 <br />DESCRIPTION OF PROPOSED WORK: <br />W HOUSE BASIC 406) <br />� P��� <br />!' � <br />:� <br />�1 �_['';�. <br />,;in <br />- <br />? �it <br />Date: <br />Public Works Permit #: <br />_�; Buildinp Permit#; <br />' 'Planninq Reference #: <br />� Public Works Fee $: <br />Other $: <br />APPLICANT NAME AND ADDRESS: <br />PHONE: <br />SITE A�ORESS: 10124 MONTANA RD <br />/ <br />02/U7/2011 <br />PW1102-002 <br />C1101-007 <br />$ 25.00 <br />NE ( <br />l�, <br />l�U 51.4' <br />r,, ?,; � <br />��, .- , <br />�. I . `!' — <br />PERMIT CONDITIONS ' ,� � <br />1. All calls for inspection shail be made 24 hours in adyance. ' <br />2. All work shall be perfermed in accordance with tlie permit anc' 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. Ccnnect rooftop downspouts to the drainage system provided for this lot. <br />5. Install erosion control measures per City of Everett Standards for smail parceis. W <br />6. All excavated materiai from foundation, sidew�lk and driveways shall be hauled lo an approved, permitted sile. � <br />No wasting of material is allowed on this building lot. � <br />7. No dirt, mud, rocks or debris to be tracked onto roadway. V1 <br />8. No building materials lo be stacked on sidewalklroadway and sidewalk/roadway to be kept clean and open `or � <br />pedestrian travel. O <br />9. Adjust water meter box 7" above sidewalk grade. � <br />10. Contact the Mukilteo Sewer District for connecting provisions for this building's �ewer services <br />YOUR PUBLIC WORKS INSPECTOR IS CLIFF LINDMAN 425-339-7404. <br />I a �PD �-f � I� 6 I I� 21 � ll <br />��,�c�� 2 -�-/� <br />�pro i for Construclion Date <br />_ �_–> �> , i <br />as Conslructed <br />Date <br />?– %� –% <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigced owner/applicant hereby agmes to hold and <br />save harmless lhe Ciry of Everett trom any and all claims for <br />dainages, costs, expenses, or causes of ac�ion Ihat may arise <br />because of installation and maintenance ot ihe improvement <br />or other ris:;?-of-way use hereto applied for and furiher agrees <br />lo remove,�ame upon notice irorp the Cily and lo replace <br />of Applicant <br />2 --� � <br />Date <br />INORK AUTHORIZEO BY THIS PER�11T D1UST BE STARTED 1NffHIN 180 DAYS OF DAT�R�1�T IS ISSUED AND THEREA�ER 15 TO BE DIUGENTLY <br />FURSUED TO COh1PLEfION. THIS PERI•11T F1AY 8E CANCELLED BY THF CITY UPON AN ST(�PPAGE OF WORK ON THIS PRO]ECT OVER 9D DAYS DURATION. <br />