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PUBLIC WORKS PERMIT Date: 10/30/2014 <br /> Public Works Permit#: PW1410-030 <br /> City of Everett Public Works Department <br /> 3200 Cedar Street Building Permit#; C1409-004 <br /> 11111:11"1—gEj <br /> _ T <br /> Everett, WA 98201 Planning Reference#: <br /> (425) 257-8810 <br /> Public Works Fee$: $ 65.00 <br /> Other $: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> BUSTARD CUSTOM CONST <br /> PO BOX 1243 <br /> MARYSVILLE WA 98270 <br /> PHONE: 4258766551 PHONE: <br /> TAX PARCEL ID# 00495801001000 SITE ADDRESS: 5921 LOWELL RD <br /> DESCRIPTION OF PROPOSED WORK: <br /> PW FOR NEW SINGLE FAMILY DWELLING <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 per City of Everett Standards for small parcels <br /> 6. All excavated material from foundation, sidewalk and driveways shall be hauled to an approved, permitted site. <br /> No wasting of material is allowed on this building lot. <br /> 7. No dirt, mud, rocks or debris to be tracked onto roadway. <br /> 8. No building materials to be stacked on sidewalk/roadway and sidewalk/roadway to be kept clean and open for <br /> pedestrian travel. <br /> 9. Per approved drainage plan. <br /> ' z <br /> C;Yi.y;Fr <br /> -r. ..R�.:7F A:,, N..... ..K:...,yry..:yt•M:F <br /> rr:'r..i•—•{i:F r.,.a::,r•i r-:•.c...>rr7 Y._;a r^� <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and <br /> save harmless the City of Everett from any and all claims for <br /> damages, costs,expenses, or causes of action that may arise <br /> > i , because of installation and maintenance of the improvement <br /> or other right-of-way use hereto applied for and further agrees <br /> to remove same upon notice from the City and to replace <br /> Appr. -• •r onstr ctio Date publi ert dama•ed thereby. <br /> ..,." de/ 3 --I 9-/ S <br /> NAL INS":CTION Date <br /> Approved as Constructed Signature of Applicant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY <br /> PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />