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PUBLIC WORKS PERMIT Date: 11/14/2013 <br /> City of Everett Public Works Department Public Works Permit #: PW1311-009 <br /> 3200 Cedar Street Building Permit #; <br /> Everett, WA 98201 Planning Reference#: <br /> (425) 257-8810 <br /> Public Works Fee 5: $ 60.00 <br /> Other $: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> JENNINGS LAWRENCE A 8 PAULA K JENNINGS LAWRENCE A 8 PAULA K <br /> 4712 5TH AVE W 4712 STH AVE W <br /> EVERETT VUq 98203 EVERETT Wq 98203 <br /> PHONE: 4252591342 PHONE: 425[5?1342 <br /> TAX PARCEL ID# 00767900000300 SITE ADDRESS: 471"L 5TH AVE W <br /> DESCRIPTION OF PROPOSED WORK: <br /> REPAIR SLIDE AREA <br /> PERMIT CONDITIONS <br /> 1. AII catls for inspection shall be made 24 hours in advance. <br /> 2. Ail 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. Any damage to sidewa!k, driveway etc. shall be replaced per City of Everett Standards. <br /> 5. Construct per approved plan. T; ���; <br /> 6. No dirt, mud, rocks or debris shall be tracked onto the roadway. " =� �.� � <br /> 7.. Contractor must contact the City of Everett inspector y;�'T � � � <br /> Randy Allen 425-339-7403 prior to starting construclion. � �; �, � <br /> ,_., <br /> r�- <br /> �_. <br /> _�. a,.,_a <br /> S'• r��•� <br /> �. � <br /> � c <br /> �� L�� <br /> 1 <br /> l�� <br /> r-� <br /> fY, <br /> � n� <br /> f.e <.. �� <br /> :�- , <br /> — t):' ^ , r/1 <br /> c�G.-. .-LV^J <br /> �' " c-�r'�;.V <br /> —��. <br /> ��� a <br /> _� <br /> ��. <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicanl hereby agrees io hold and <br /> � save harmless Ihe City of Everett from any and all claims lor <br /> damages, costs,exper��es,or causes of action that may arise <br /> / because of installalion ar:�maintenance of the improvement <br /> �` 3 i� ��/u'� or other right-of-�vay use hereto applied for and(urther agrees <br /> r or onsir D e /j' �o rem me upon notice from the Cily and to replace <br /> PP e � publicprope amagedthereby. <br /> . q --�14= ' - <br /> INAL INSP - TION Date `� --' � � � <br /> Approved as Constructed Signature of ApF ' Date <br /> WORK AUTHORIZED BY THIS PERPIIT MUST 0E STARTED IVITFiIN 180 DAYS OF DATE PERMfi]S ISSUED AND THEREAFfER IS TO 6E DILIGEfVTLY ��, <br /> PURSUED TO COMP�ETIOY. THIS PERhllT MAY BE UNCELLED BY THE C11Y UPON�NY STOPPAGE OF WGkK ON THIS PRO)ECT OVER 90 DAYS DURATION. �I <br />