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PUBLIC WORKS PERMIT Date Applied: 7/9/2010 <br /> City of Everett Permit Services Public Works Permit#: PW1007-005 <br /> 3200 Cedar Street, 2"d Floor Associated Bldg Permit#: C0912-015 <br /> Everett,WA 98201 Planning Reference#: NCB09-018 <br /> (425)257-8810 Public Works Fee: $25 <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> STARZL TERENCE H OWNER <br /> 1202 RUCKER AVE <br /> EVERETT, WA, 98201 , , <br /> PHONE: 3605366924 PHONE: <br /> TAX PARCEL ID#: 00409422601700 SITE ADDRESS: 1202 RUCKER AVE <br /> DESCRIPTION: CLOSED-SIDEWALK REPAIR ON 12TH ST <br /> 9/20/13 PERMIT NEVER PICKED UP <br /> THIS PERMIT TO BE POSTED ON JOB SITE AT ALL TIMES <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 for Development'. <br /> 3. Call Location Underground Service 48 hours before you dig. The day you call does not count. TOLL FREE NUMBER 811. <br /> 4. No dirt, mud, rocks or debris to be tracked onto roadway. <br /> 5. Remove and replace curb, gutter and sidewalk as per City of Everett Standard Plan#'s 305A& 306 on this proposal's <br /> frontage as directed by the Public Works Inspector(i.e. all unused driveways and any broken or damaged area must be <br /> replaced). <br /> Your inspector is Randy Allen, 425-339-7403 <br /> City of Everett Official Use Only ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save <br /> harmless the City of Everett from any and all claims for damages,costs, <br /> expenses,or causes of action that may arise because of installation and <br /> maintenance of the improvement or other right-of-way use here to applied <br /> Approved for Construction (Public Works) Date for and further agrees to remove same upon notice from the City and to <br /> replace public property damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed (PW Inspector) 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 PURSUED TO <br /> COMPLETEION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90-DAY DURATION. <br />