1816 112TH ST SE 2017-03-16 - Laserfiche WebLink

OW . PUBLIC nrORKS PERMIT Date: 3/22/2016 ;f City of Everett Public Works Department Public Works Permit#: PW1603-049 3200 Cedar Street Parent Permit#: vow./ Everett, WA 98201 Planning Reference#: (425) 257-8810 Public Works Fee$: $ 65.00 Other $: OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: SHELL OIL PRODUCTS U.S. BLAINE TECH SERVICES INC. 20945 S WILMINGTON AVE. 20735 BELSHAW AVE. CARSON CA 90810 CARSON CA 90746 PHONE: 4254131164 PHONE: 3108854455 TAX PARCEL ID# 00494200400200 SITE ADDRESS: 1816 112TH ST SE GROUND WATER MONITORING (12/26/2013 11:06 AM BES) ROUTINE GROUND WATER MONITORING OF EXISTING WELL(MW-16) PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hours in advance. 2. All work shall be performed in accordance with the permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 -.: .r"i 4. Traffic Control must be done in accordance with the approved Traffic Control Plan ---.'-j,_. : {,'1-4 ' and the MUTCD as applicable. --1-,-, -.-,,--, 5. Any damage to the City sidewalk, curb, roadway, or other improvements shall be i ' i_.rs r=":' replaced per City of Everett Standards and at the direction of the City's Public Works iii Inspector. :'5,-::.3. "'' I 7. Contact the City of Everett Public Works Inspector Jim Knappert 425-339-7404 prior to starting construction, to evaluate traffic control set-up, and with other inspection ' F '- 0 requests. See attached to request an inspection. E"j y - r-:1 ' '- Public Works Permit Fee Breakdown: ;:�; Misc Minor Permits And/Or Plan Reviews $25.00 PW Plan Review $20.00 PW Site Inspection $20.00 PO ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harmless the City of Everett from any and all claims for damages, costs,expenses,or A�-1 � �` 3 22_, k/,‘, causes of action that may arise because of installation and maintenance of the improvement or other right-of-way use hereto applied for and further agrees to Ap•li-• for Construc 7 Date remove same upon notice from the City and to replace public property damaged th/reby. / FINAL INSPECTION Date t ,� /si (n, ' (.7-5(14 . Approved as Constructed Sigha re of Applica Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. FT( £