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PUBLIC WORKS PERMIT Date� 1 1/1 4120 1 3 <br /> "' Public Works Permit #: PW1311-009 <br /> \ �' Gry of Everett Public Works Department <br /> `T 3200 Cedar Street Buildinp Permit #; <br /> �� � Everett, WA 987_01 <br /> � Planning Reference #. <br /> (425) 257-8810 <br /> Public Works Fee �: 5 60.00 <br /> Other 5: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> JENNINGS LAWRENC[ A E PAULA K JFNNWGS LAWRENC[ A & PAULA K <br /> 4712 5TH AVE W 4712 5TH AVE W <br /> EVERETT Wq 98203 EV[RETT �n/q 98203 <br /> PHONE: 4252591342 PHONE: 4252591342 <br /> TAX PARCEL ID# 00767900000300 SITE ADDRESS: 4712 5TH AVE W <br /> DESCRIPTION OF PROPOSED WORN: <br /> REPAIR SLIDE AREA <br /> PERMIT CONDITIONS <br /> t All cails (or 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 Specificalions <br /> 3. Call Lecation Underground Service 48 hrs b2fore you dig. TOLL FREE NUMBER 811 <br /> 4. Any damage to sidewalk, driveway etc shall be replaced per City of Everett Standards T <br /> 5 C�nstruct per approved plan. ;: C��' <br /> 6 No dirt, mud, rocks or debris shall be tracked onto the roadway. '�� :; !z" F <br /> 7.. Contractor must contact lhe City of Everett inspector y)�s ^ � <br /> Randy Allen 47_5-339-7403 prior to starting construction. �, �-, � � <br /> _, <br /> �� � <br /> .. n'�`�O <br /> � <br /> �"�'� <br /> r_ <br /> S � 1�. ,�' ° <br /> Q ,� �� �d�S u �; <br /> ,, _� <br /> �e � �,<` r � 16 ;c` c 'O <br /> 2 J1 O C�r � ^ <br /> � - ��� <br /> �• _ <br /> ACKNOWLEDGEMENT OP CONDITIONS <br /> The undersigned o�vnedapplicant here6y agrees to hold and <br /> save harmless the Cily of[verett(rom any and all claims for <br /> / damages, costs, expenses, or causes of action that may aiise <br /> � / because o(ins�allation and maintenance of Ihe improvement <br /> .----�-- � y 2�� or olher right-o6way use herelo applied for and further agrees <br /> � i to rem me upon notice from the Ciry and to replace <br /> pp�ov d (or Construc)i n Da e � public prope amaqed thereby. <br /> � <br /> FWAL INSPECTION Date � — — _ � � <br /> � <br /> Approved a5 ConStruCled Signature of Ap � Date <br /> WORK AUTHORIZED BY THIS PERh1R MUST BE STARTED 6VRHiN 180 DFYS Of DATE f"eR�d!T 15 ISSUED AND THEREA�ER IS TO BE DILIGENiLY <br /> PURSUED TO COI4PLETION. THIS PERh1R tdAY B[CANC[LLEO 6Y THF-CIN UPON ANY Sl OPPAGE OF WORK 0^7 THIS PROJEC7 OVER 90 DAYS DURATION. <br /> P� <br />