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PUBLIC WORKS PERMIT <br />City of Everett Public Works Department <br />3200 Cedar Street <br />Everett, WA 98201 <br />(425) 257-8810 <br />OWNER NAME AND ADDRESS: <br />OWENS GREGORY <br />118 69TH ST SE <br />EVERETT WA 98203 <br />PHONE: 4253476436 <br />AX PARCELIO # 00392000003101 <br />DESCRIPTION OF PROPOSED WORK: <br />NEW MFG SFR <br />Date. <br />9114/2012 <br />Public Works Permit #: <br />PW1209-011 <br />Buildinq Permit #. <br />B1208-008 <br />Planninq Reference #: <br />Public Works Fee $ <br />$ 25.00 <br />Other $ <br />APPLICANT NAME AND ADDRESS: <br />PHONE: <br />SITE ADDRESS: 123 69TH PL SE <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, Cell Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 — <br />4 The contractor must meet with the Public Works Inspector to discuss potential drainage routing prior to w <br />begmnm4 the project. Cal�t 425-339-74C� <br />5. Install erosion control m S asn rmined by the Public Works inspector, such as silt fence, straw bales, <br />swales, or erosion blankets. [fm <br />6. Instal7. Pave ( erosion control measues per driveway from the iontrpr perty cline out to the steetpavingof Everett Standrds forsmall parcels. <br />C <br />�7 <br />z <br />C <br />C <br />TO POSTING �' 1 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned ownerlapplicant hereby agrees to hold and <br />save harmless the City of Everett from any and all claims for <br />damages, .Osts, expenses, or causes of action that may arise <br />because of installation and maintenance of the improvement <br />or other right-of-way use hereto applied for and further agrees <br />to remove some upon notice from the City and to replace <br />public property damaged thereby. <br />Signature Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT 15155UED 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 DURt-TIOR <br />